Journal of chemotherapy (Florence, Italy) · 2016
What does the susceptible-dose dependent interpretive category for cefepime in ESBL-producing bacteria?
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Menegucci Thatiany Cevallos, Bastos Marina de Souza, Viana Giselle Fukita, Moreira Rafael Renato Brondani, Garcia Lourdes Botelho, Cardoso Celso Luiz, Tognim Maria Cristina Bronharo
Аннотация
In this study, we investigated the frequency of isolates included in the susceptible-dose dependent (SDD) category, according to the Clinical and Laboratory Standards Institute guidelines, carrying blaTEM, blaSHV and blaCTX genes among 92 Klebsiella pneumoniae and 80 Enterobacter cloacae clinical isolates. The presence of one or more extended-spectrum β-lactamases (ESBLs) genes was observed in 64% K. pneumoniae and 69% E. cloacae isolates. Nineteen isolates were included in SDD interpretive category criteria, of which 15 carried ESBL genes (seven K. pneumoniae and eight E. cloacae). Considering the high proportion of ESBL gene-containing isolates included in the SDD category (79%), we recommend that physicians exercise caution in the use of cefepime for treatment of infections caused by these isolates, reducing possible therapeutic failure, particularly in cases of ESBL-producing bacterial strains.
Предметные рубрики MeSH
Anti-Bacterial AgentsBacterial ProteinsBrazilCefepimeCephalosporinsDrug Resistance, BacterialDrug Resistance, Multiple, BacterialEnterobacter cloacaeEnterobacteriaceae InfectionsGenes, BacterialHumansInactivation, MetabolicIntensive Care UnitsKlebsiella InfectionsKlebsiella pneumoniaeMicrobial Sensitivity TestsMolecular TypingPractice Guidelines as Topicbeta-Lactamases