Kanaujia Rimjhim, Kaur Satinder, Biswal Manisha, Ray Pallab, Sharma Navneet, Angrup Archana
Department of Medical Microbiology, PGIMER, Chandigarh, Chandigarh, 160012, India.
Department of Microbiology, Punjab Institute of Liver and Biliary Sciences, Mohali, Punjab, India.
Eur J Clin Microbiol Infect Dis. 2025 Mar;44(3):753-757. doi: 10.1007/s10096-024-05033-0. Epub 2025 Jan 3.
Cefepime-tazobactam (FEP-TAZ) consists of cefepime combined with tazobactam, a penicillanic acid-sulfone recognized as an established beta-lactamase inhibitor. This study aims to investigate the in-vitro effectiveness of FEP-TAZ against cefepime-resistant clinical isolates of Escherichia coli (E. coli). A total of 105 E. coli clinical isolates characterized by cefepime-resistant/susceptible dose-dependent and carbapenem-sensitive profiles were tested for susceptibility by broth microdilution (BMD) method against cefepime and FEP-TAZ (tazobactam at a fixed concentration of 4 mg/L). Minimum inhibitory concentration (MIC) values for cefepime were determined using the Clinical and Laboratory Standards Institute (CLSI) broth microdilution method (M100-2022). Simultaneously, we also performed Disk-diffusion (DD) to observe the concordance between BMD and DD. FEP-TAZ exhibited inhibitory efficacy against 83.8% of E. coli isolates, markedly reducing the geometric mean from 20.4 to 1.9. Comparative analysis with DD revealed concordance with MIC for all isolates except four isolates. FEP-TAZ demonstrated potent activity against E.coli. This may be used as a carbapenem-sparing agent for the treatment of serious infections caused by cefepime-resistant Gram-negative bacilli. Furthermore, in settings where BMD implementation poses challenges, the pragmatic application of DD proves to be a viable alternative.
头孢吡肟-他唑巴坦（FEP-TAZ）由头孢吡肟与他唑巴坦组成，他唑巴坦是一种公认的青霉素酸砜类β-内酰胺酶抑制剂。本研究旨在探讨FEP-TAZ对耐头孢吡肟的大肠埃希菌临床分离株的体外有效性。通过肉汤微量稀释（BMD）法，对总共105株具有耐头孢吡肟/剂量依赖性敏感和碳青霉烯敏感特征的大肠埃希菌临床分离株进行了头孢吡肟和FEP-TAZ（他唑巴坦固定浓度为4mg/L）的药敏试验。采用临床和实验室标准协会（CLSI）肉汤微量稀释法（M100-2022）测定头孢吡肟的最低抑菌浓度（MIC）值。同时，我们还进行了纸片扩散法（DD），以观察BMD和DD之间的一致性。FEP-TAZ对83.8%的大肠埃希菌分离株表现出抑制作用，几何平均值从20.4显著降低至1.9。与DD的比较分析显示，除4株分离株外，所有分离株的MIC结果均一致。FEP-TAZ对大肠埃希菌显示出强大的活性。这可作为一种碳青霉烯类药物节省剂，用于治疗由耐头孢吡肟的革兰氏阴性杆菌引起的严重感染。此外,在实施BMD存在挑战的情况下，DD的实际应用被证明是一种可行的替代方法。
