title: Increased cefepime MIC for enterobacteriacae clinical isolates.
abstract: Background : Cefepime was used as empirical treatment in ventilator-associated pneumonia (VAP) induced by gram-negative and gram-positive bacteria. This study aimed to determine the antimicrobial susceptibility pattern of cefepime against microorganism causing VAP in Mazandaran, North of Iran.
  
  
  METHODS
  This study was performed on VAP patients diagnosed with clinical pulmonary infection score (CPIS) scores in ICU of two hospitals. For each patient suspected of having VAP, quantitative culture of endotracheal aspiration (QEA) was performed and MIC was determined by micro dilution test. Data were collected and analyzed.
  
  
  RESULTS
  Thirty- five cases of enterobacteriaceae were isolated orderly including E coli 13, P. aeruginosa 11, Enterobacter 7 and K. pneumonia 4 cases. All the isolated E. coli, Enterobacter and Klebsiella, 54.5% of P. aeruginosa isolated were fully resistant to cefepime.
  
  
  CONCLUSIONS
  The results of this study show that cefepime is not a reasonable choice for empirical treatment of nosocomial pneumonia and VAP.
authors.affiliation: Tropical Medicine and Microbial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Narges
authors.initials: N
authors.lastname: Najafi
authors.forename: Ahmad
authors.initials: A
authors.lastname: Alikhani
authors.forename: Farhang
authors.initials: F
authors.lastname: Babamahmoudi
authors.forename: Alireza
authors.initials: A
authors.lastname: Davoudi
authors.forename: Roya
authors.initials: R
authors.lastname: Ghasemiyan
authors.forename: Shahriar
authors.initials: S
authors.lastname: Aliyan
authors.forename: Arman
authors.initials: A
authors.lastname: Shoujaiifar
keywords: Cefepime; Enterobacteriacae; ICU; MIC; VAP