Antimicrobial activity of cefepime-tazobactam combination against extended spectrum beta-lactamase and/or AmpC beta-lactamase- producing gram-negative bacilli

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Elawady B.A.; Mahmoud N.R.; Badawi H.E.-S.; Badr A.E.E.; Gohar N.M.

Journal: BMC Infectious Diseases

Publisher: BioMed Central Ltd

Publication Date: 23 April 2024

Volume / Issue: Volume 24 / Issue 1

Article No.: 434

ISSN: 14712334

DOI: 10.1186/s12879-024-09296-y

Scopus: View on Scopus

PubMed: 38654148

Document Type: Article

Access: All Open Access; Gold Open Access; Green Open Access

Authors and Affiliations

Elawady B.A., Medical Microbiology and Immunology Department, Faculty of Medicine, Cairo University, Cairo, Egypt; Mahmoud N.R., Medical Microbiology and Immunology, Theodor Bilharz Research Institute, Warraq Al Hadar, Egypt; Badawi H.E.-S., Medical Microbiology and Immunology, Theodor Bilharz Research Institute, Warraq Al Hadar, Egypt; Badr A.E.E., Medical Microbiology and Immunology Department, Faculty of Medicine, Cairo University, Cairo, Egypt; Gohar N.M., Medical Microbiology and Immunology Department, Faculty of Medicine, Cairo University, Cairo, Egypt

Abstract

Background: The problem of resistance to beta-lactam antibiotics, which is caused by ESBL and AmpC β-lactamases, is getting worse globally. Infections caused by bacterial isolates harboring these enzymes are difficult to treat with carbapenems being the sole effective treatment option for such infections. The objective of this study was to determine the frequency of ESBLs and AmpC-producing Gram-negative bacilli isolated from clinical specimens and to evaluate the sensitivity of cefepime-tazobactam combination against them. Methods: This is an observational cross-sectional study carried out on 100 Gram-negative bacilli at Theodor Bilharz Research Institute Hospital during the period from February 2015 to January 2016. ESBL production was screened by using the disc diffusion test followed by confirmation by the combined disc confirmatory test, the screening for AmpC production was conducted using the cefoxitin disc test, which was subsequently confirmed by the AmpC disc test. Isolates confirmed positive for ESBL and/ or AmpC production were investigated for their susceptibility to antibiotics. Results: Among 100 Gram-negative bacilli, 44 isolates were confirmed as ESBL producers by the combined disc confirmatory test out of 56 isolates that tested positive for ESBL production through the disc diffusion test. The presence of AmpC production was assessed using the cefoxitin disc test, 32 isolates were screened to be AmpC producers, and the AmpC disc test confirmed AmpC production in 9 isolates of them. Using the Mast® D68C set, 32 isolates were ESBL producers, 3 were AmpC producers, and 4 isolates were ESBL/AmpC co-producers. The highest sensitivity was to cefepime-tazobactam (91.48%) followed by the carbapenems. Conclusion: Cefepime-tazobactam showed remarkable activity against ESBL and/or AmpC-producing Gram-negative bacilli and may be considered as a therapeutic alternative to carbapenems. © The Author(s) 2024.

Keywords

AmpC; Cefepime-tazobactam; ESBL; Gram-negative bacilli; Anti-Bacterial Agents; Bacterial Proteins; beta-Lactamases; Cefepime; Cephalosporins; Cross-Sectional Studies; Female; Gram-Negative Bacteria; Gram-Negative Bacterial Infections; Humans; Male; Microbial Sensitivity Tests; Penicillanic Acid; Tazobactam; amikacin; aztreonam; beta lactamase AmpC; carbapenemase; cefotaxime; cefoxitin; ceftazidime; ciprofloxacin; colistin; extended spectrum beta lactamase; AmpC beta-lactamases; antiinfective agent; bacterial protein; beta lactamase; cephalosporin derivative; antibiotic resistance; antibiotic sensitivity; antimicrobial activity; Article; Bacilli; bacterium detection; bacterium identification; bacterium isolate; controlled study; cross-sectional study; disk diffusion; Enterobacter cloacae; Escherichia coli; Klebsiella pneumoniae; minimum inhibitory concentration; nonhuman; observational study; Providencia stuartii; Pseudomonas aeruginosa; Serratia marcescens; zone of inhibition; drug effect; enzymology; genetics; Gram negative bacterium; Gram negative infection; human; isolation and purification; metabolism; microbial sensitivity test; microbiology

Citation Information

Scopus Citations: 6

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