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Vol. 15. Issue 2.
Pages 167-169 (March - April 2011)
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Vol. 15. Issue 2.
Pages 167-169 (March - April 2011)
Brief Communication
Open Access
Cefepime versus extended spectrum β-lactamase-producing Enterobacteriaceae
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Keite da Silva Nogueira1,
Corresponding author
keitenogueira@hotmail.com

Correspondence to: Rua Comendador Macedo, 275. Ap.63. 80060-030 Centro, Curitiba, Paraná, Brazil.
, Alessandra Vale Daur1, Iara Taborda de Messias Reason2, Ana Cristina Gales3, Libera Maria Dalla Costa2
1 Pharmacist, Hospital de Clínicas, Universidade Federal do Paraná - UFPR, Curitiba, Brazil
2 Researcher, Hospital de Clínicas, UFPR, Curitiba, Brazil
3 Laboratório Alerta, Universidade Federal de São Paulo, São Paulo, Brazil
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Abstract

The objective of this study was to evaluate the susceptibility to cefepime of a large group of ESBL-producing enterobacteria recently isolated in a Brazilian teaching hospital. The study included 280 strains of ESBL-producing enterobacteria, isolated between 2005 and 2008. The presence of the genes blaCTX-M, blaTEM and blaSHV was determined by PCR and confirmed by nucleotide sequencing. Susceptibility testing for cefepime was performed by disc-diffusion, agar dilution method and E-test®. Among the isolates, 34 (12.1%) presented a cefepime inhibition zone ≥ 21 and MIC ≤ 8mg/L by agar dilution and E-strip methods. The use of cefepime for the treatment of infections caused by ESBL-producing bacteria has been controversial. Some studies of PD/PK show the probability of achieving the required PD parameters for cefepime, when the MICs were <8mg/L, whereas others have reported therapeutic failure with the same MIC. Additional data is essential to come to terms about the report and treatment with cefepime in ESBL-producing organisms especially when these microorganisms are isolated from sterile sites and from critically ill patients.

Keywords:
enterobacteriaceae
beta-lactamases
cephalosporin resistance
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Copyright © 2011. Elsevier Editora Ltda.. All rights reserved
The Brazilian Journal of Infectious Diseases
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