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. 2017 Jun;29(3):189-194.
doi: 10.1080/1120009X.2015.1120407. Epub 2016 Feb 6.

What does the susceptible-dose dependent interpretive category for cefepime in ESBL-producing bacteria?

Thatiany Cevallos Menegucci  1 , Marina de Souza Bastos  1 , Giselle Fukita Viana  1 , Rafael Renato Brondani Moreira  1 , Lourdes Botelho Garcia  1 , Celso Luiz Cardoso  1 , Maria Cristina Bronharo Tognim  1
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What does the susceptible-dose dependent interpretive category for cefepime in ESBL-producing bacteria?

Thatiany Cevallos Menegucci et al. J Chemother. 2017 Jun.

Abstract

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.

Keywords: Cefepime; Enterobacter cloacae; Extended-spectrum β-lactamase; Klebsiella pneumoniae; Minimum inhibitory concentration; Susceptible-dose dependent.

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