Susceptibility profile of Gram-negative bacteremic isolates to beta lactam-beta lactamase inhibitor agents in comparison to other antibiotics

Abdul, King; Vidyalakshmi, PR; Jayalakshmi, VA; Poojary, Ishna

doi:10.4103/0019-509x.175361

Cited by 5 publications

(5 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Surprisingly, cefoperazone /sulbactam and cefepime/tazobactam performed comparatively better than carbapenems against Pseudomonas. Similar to our observations, Abdul et al [15] have also reported that BL-BLI combinations performed better than carbapenems against pseudomonas.…”

Section: Discussionsupporting

confidence: 92%

See 1 more Smart Citation

Current Susceptibility Trend of Antibiotics in a Tertiary Care Hospital - Need to Emphasize on Alternate Therapeutic Agents

Khandait¹,

Bansal

Mandale

2019

MRJI

View full text Add to dashboard Cite

Introduction: In the light of changing anti-microbial resistance pattern, the understanding of the local antibiogram is essential in the antibiotic selection procedures and preparation of hospital antibiotic policy. Aim: This retrospective study was aimed to analyze the antibacterial susceptibility pattern of major isolates from ICU and IPD. Materials and Methods: Antimicrobial susceptibility testing was done for a total of 565 Gram-negative isolates including E. coli, K. pnuemoniae, A. baumannnii and P. aeruginosa from ICU and IPD patients enrolled between July 2016 to December 2016. Results: The majority of the isolates were reported from urine samples (52%) in IPD and sputum (59%) in ICU. The susceptibility to BL/BLI was 50-75% in IPD patients and Carbapenem susceptibility was reported in more than 75% except P. aeruginosa. In ICU patients, the beta-lactam/beta-lactam inhibitor (BL/BLI) susceptibility ranged between 20-60% and the carbapenem susceptibility was around 40%-75%. The susceptibility of CSE-1034 (Ceftriaxone + Sulbactam + EDTA) was almost similar to minocycline and amikacin ranging from 50-90% against different species. Compared to carbapenems, the CSE-1034 performed overall better than carbapenems against P. aeruginosa and A. baumannii and was comparable to carbapenems against Enterobacteriaceae. The susceptibility of colistin ranged from 92-97% in both IPD and ICU isolates. Conclusion: Considering the value of carbapenems and colistin as the last option for multi-drug resistant (MDR) bacterial infections, irrational prescription of these drugs should be stopped. The use of ampicillin-sulbactam, cefepime and gentamicin from 1st line antibiotics in ICU patients can help to reduce the load on 2nd line antibiotics. Among 2nd line drugs, CSE-1034 along with amikacin should be an empirical choice of treatment for bacterial infections where the 1st line drugs are suspected to fail and the need of carbapenems arises.

show abstract

Section: Discussionsupporting

confidence: 92%

“…The antibiotic susceptibility reported by Abdul et al [15] for different antibiotics tested is also almost similar to our pattern. Increase in carbapenems resistance has been linked with excessive carbapenem consumption.…”

Section: Discussionsupporting

confidence: 92%

Current Susceptibility Trend of Antibiotics in a Tertiary Care Hospital - Need to Emphasize on Alternate Therapeutic Agents

Khandait¹,

Bansal

Mandale

2019

MRJI

View full text Add to dashboard Cite

show abstract

“…Addition of tazobactam increased the susceptibility of from 32% to 90% in E. coli, from 16 to 41.0% in Klebsiella, from 86.0 to 87% in Pseudomonas and Proteus from 80% to 100%. This study highly correlates with Abdul Kafur et al 13 Cefepime/tazobactam having better coverage than Cefepime, Cefoperazone-sulbactam, Piperacillin Tazobactam and Ceftazidime Tazobactam correlates with my previous sudy. 14 Cefepime tazobactam (30/10 μg) combination was found to be very effective against many ESBL producing Gram negative organism.…”

Section: Discussionsupporting

confidence: 89%

Antimicrobial Sensitivity of Gram-Negative Bacteria With Beta Lactam /Beta Lactamase Inhibitor Combination of Drugs in Comparison to Other Antibiotics in Tertiary Care Center

Rammurugan¹,

Sasireha²

2019

jemds

View full text Add to dashboard Cite

BACKGROUND Objectives of the study were-1. isolation and speciation of Gram-negative bacteria from urine, pus sample, wound swab, blood, tissue, BAL and other body fluids. 2. To identify bacteria most commonly isolated in ICU and Non-ICU Samples. 3. To compare sensitivity and resistant patterns of beta lactam and beta lactamase inhibitor combination of drugs, carbapenem, and aminoglycosides in various Gram-negative bacterial isolates. Bacterial isolates are compared with MIC testing (E test) for Cefepime Tazobactam (CPT) and disc diffusion method. MATERIALS AND METHODS Gram negative bacterial pathogens from various clinical samples (urine, blood, broncho-alveolar lavage [BAL], other body fluids (bile, endometrial secretions), pus, wound swab, sputum and vaginal swab) were included in this study. The Isolates were identified with a battery of standard biochemical tests. Cefepime/tazobactam (CPT) (30/10 μg HiMedia, Mumbai) against various bacterial isolates and their susceptibility were compared with other β-lactam/β-lactamase inhibitor combinations like piperacillin/ tazobactam (PTZ), cefoperazone/sulbactam (CFS), carbapenems [imipenem (IMP), meropenem (MRP) and Amikacin]. MIC determination paper strip which is coated with Cefepime/Tazobactam on a single paper strip in a concentration gradient capable of showing MICs in the range of 0.016 mcg/ml to 256 mcg/ml, on testing against the test organism. RESULTS A total of 130 isolates from patients attending the tertiary care teaching hospital were included in the study. Most common age groups of isolation of Gram-negative bacilli was 40-60 yrs. and above 60 yrs. Out of 130 isolates isolated, 68 isolates were from male patients and 53 isolates were from female patients, 7 isolates were from male children and 2 isolates were from female children. Out of 130 isolates isolated, most common area of isolation of Gram-negative bacilli were from Inpatient (IP) from various wards, Out Patient (OP) and ICU. Out of 130 isolates isolated, most common samples were from urine, blood, pus and wound swab. Out of 130 samples isolated, 43% were from Escherichia coli, 24% were from Klebsiella pneumoniae, 18% were from Pseudomonas aeruginosa, 5% were from Enterobacter species and 3% were from Proteus species. Among 43% E. coli isolates, the sensitivity pattern towards, Cefepime Tazobactam was 90%, Cefepime-32%, Piperacillin Tazobactam-75%, Cefoperazone sulbactam-71%, Carbapenem-91%, and Amikacin-92%. Klebsiella Pneumoniae (24%) showed susceptibility of 42% on Cefepime Tazobactam, Cefepime-16%, Piperacillin Tazobactam-48%, Cefoperazone sulbactam-46%, Carbapenem-55%, and Amikacin 55%. Pseudomonas aeruginosa (18%) showed highest susceptibility of 87% Sensitivity to Cefepime Tazobactam, Cefepime, Carbapenem and Amikacin followed by 70% Sensitivity to Piperacillin Tazobactam and Cefoperazone sulbactam. Proteus spp. showed 100 % susceptibility to Cefepime Tazobactam, Cefoperazone sulbactam, Carbapenem and Amikacin followed by 80% sensitivity to Cefepime, Piperacillin Tazobactam. Citrobacter spp...

show abstract

“…8,9 Very few previous Indian studies have evaluated and compared the in -vitro activity of the following three βlactam and β-lactamase inhibitor combinations piperacillin-tazobactam, cefoperazone sulbactam and cefepime tazobactam. In the present study, cefepime tazobactam has better susceptibility than the other two BL/BLI combination tested, same was reported by Sood S et al, and Abdul K et al 9,10 Further, it has also been demonstrated in this study that in comparison to cefepime the cefepime-tazobactam combination exhibited good activity against E. coli, Klebsiella pneumoniae, Acintobacter baumanii as well as Pseudomonas aeruginosa. The increased susceptibility percentage of cefepime in combination formulation with tazobactam was also shown by Sood S et al, and Susan M et al 9,11 The current data reveals an interesting picture of a very comparable susceptibility of Enterobacteriaceae (fermenters) to CPM/TZ (77.2%) and carbapenems (82.5% to 83.5%).…”

Section: Discussionsupporting

confidence: 89%

Cefepime/tazobactam as a new treatment option for multidrug resistant gram negative bacilli

Agarwal¹,

Agarwal²,

Tewari³

et al. 2019

Int J Res Med Sci

View full text Add to dashboard Cite

Background: Every time an antibiotic is used, whether appropriately or not, the probability of the development and spread of antibiotic resistant bacteria is increased. Thus, multidrug resistant bacteria particularly ESBL (Extended spectrum βlactamase), Amp C and carbapenemases producing gram negative bacilli have emerged as a major health problem all over the world. Considering new treatment options as a carbapenems sparing and resistance prevention modality, this study was aimed to know the in vitro susceptibility pattern of Cefepime/Tazobactam (CPM/TZ) in comparison to other β-Lactam/ β-Lactamase inhibitors (BL/BLI) and carbapenems against GNB.Methods: A prospective study was conducted on all clinical samples received for a period of about 1 year. Identification and susceptibility of all isolates was done by Vitek 2 Compact system. Susceptibility of CPM/ TZ was done by disc diffusion method on the basis of CLSI guidelines. Both fermenters (E. coli and Klebsiella pneumoniae) and non-fermenters (Acintobacter baumanii and Pseudomonas aeruginosa) were included in the study.Results: Out of 550 GNB isolates the most common was E. coli (61.8%), Acintobacter baumanii (16%), Klebsiella pneumoniae (14.9%) and Pseudomonas aeruginosa (7.3%). Cefepime/tazobactam had a much higher susceptibility of 68% compared to cefepime (28%). Among the BL/BLI combinations tested cefepime/tazobactam (68%) showed the maximum percentage of susceptibility followed by cefoperazone/sulbactam (61.5%) and piperacillin/tazobactam (57.6%). Amongst all GNB isolates cefepime/tazobactam (68%) sensitivity was very much comparable to imipenem (71.8%) and meropenem (69.6%).Conclusions: CPM/TZ exhibited the best in vitro activity in comparison to the other BL/BLI. This new combination of cefepime/tazobactam appears to be a promising alternative therapeutic option to carbapenems. Clinical studies are needed to confirm this in vitro study result.

show abstract

Susceptibility profile of Gram-negative bacteremic isolates to beta lactam-beta lactamase inhibitor agents in comparison to other antibiotics

Abstract: Findings of the study make a strong argument for using BL-BLI agents and sparing carbapenem to curtail the spiraling scenario of carbapenem resistance.

Cited by 5 publications

References 4 publications

Current Susceptibility Trend of Antibiotics in a Tertiary Care Hospital - Need to Emphasize on Alternate Therapeutic Agents

Current Susceptibility Trend of Antibiotics in a Tertiary Care Hospital - Need to Emphasize on Alternate Therapeutic Agents

Antimicrobial Sensitivity of Gram-Negative Bacteria With Beta Lactam /Beta Lactamase Inhibitor Combination of Drugs in Comparison to Other Antibiotics in Tertiary Care Center

Cefepime/tazobactam as a new treatment option for multidrug resistant gram negative bacilli

Contact Info

Product

Resources

About