Increased cefepime MIC for enterobacteriacae clinical isolates

Area of Science:

• Microbiology
• Infectious Diseases
• Clinical Pharmacy

Background:

• Cefepime is frequently used for empirical treatment of ventilator-associated pneumonia (VAP).
• VAP is often caused by Gram-negative and Gram-positive bacteria.
• Understanding local antimicrobial susceptibility patterns is crucial for effective treatment.

Purpose of the Study:

• To determine the antimicrobial susceptibility pattern of cefepime against microorganisms causing VAP.
• To evaluate the effectiveness of cefepime as an empirical treatment for VAP in Mazandaran, Iran.

Main Methods:

• The study included VAP patients diagnosed with clinical pulmonary infection score (CPIS) in intensive care units.
• Quantitative culture of endotracheal aspiration (QEA) was performed for VAP patients.
• Minimum inhibitory concentration (MIC) of cefepime was determined using microdilution tests.

Main Results:

• Thirty-five cases of Enterobacteriaceae were isolated, including E. coli (13), P. aeruginosa (11), Enterobacter (7), and K. pneumoniae (4).
• High resistance rates to cefepime were observed: all E. coli, Enterobacter, and K. pneumoniae isolates were resistant.
• 54.5% of P. aeruginosa isolates also showed full resistance to cefepime.

Conclusions:

• Cefepime exhibits significant resistance among common VAP pathogens in this region.
• The findings indicate that cefepime is not a reliable empirical treatment option for nosocomial pneumonia and VAP.
• Local antimicrobial surveillance is essential for guiding empirical therapy choices.