title: Susceptibility profile of Gram-negative bacteremic isolates to beta lactam-beta lactamase inhibitor agents in comparison to other antibiotics.
abstract: BACKGROUND
  Comprehensive understanding about the local antibiogram is an essential requirement for preparation of hospital or unit based antibiotic policy. Bacteremic isolates are the most useful ones for this purpose, representing invasive disease.
  
  
  OBJECTIVE
  To analyze susceptibility pattern of bacteremic Gram-negative isolates in our center, to various antibiotics, including beta lactam-beta lactamase inhibitor (BL-BLI) agents and carbapenem.
  
  
  METHODS
  This is a retrospective study done in Apollo Specialty Hospital, a tertiary care oncology center in South India. The susceptibility of Escherichia coli, Klebsiella, Acinetobacter and Pseudomonas blood culture isolates, identified between January 2013 and June 2014 to various antibiotics were analyzed.
  
  
  RESULTS
  A total of 231-Gram-negative bacteremic isolates were analyzed. ESBL rate among E. coli isolates was 82.7% (67 out of 81) and 74.3% (58 out of 78) in Klebsiella. Carbapenem (imipenem) susceptibility rate in E. coli was 76.5%, Klebsiella 58.9%, Acinetobacter 32% and Pseudomonas 77.2%. Colistin susceptibility in E. coli was 96.2%, Klebsiella 93.5%, Acinetobacter 92.8% and Pseudomonas 97.7%. Difference in the susceptibility of Enterobacteriaceae to BL-BLI agents (especially cefepime-tazobactam) and carbapenem were minimal. In nonfermenters, BL-BLI susceptibility was better than that of carbapenem.
  
  
  CONCLUSIONS
  Findings of the study make a strong argument for using BL-BLI agents and sparing carbapenem to curtail the spiraling scenario of carbapenem resistance.
authors: Department of Infectious Diseases, Apollo Specilaity Hospitals, Chennai, Tamil Nadu, India.
authors: K
authors: K
authors: Abdul  Ghafur
authors: P R
authors: PR
authors: Vidyalakshmi
authors: V A
authors: VA
authors: Jayalakshmi
authors: I
authors: I
authors: Poojary
mesh_terms: D000150:Acinetobacter / Q000187:drug effects; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016470:Bacteremia / Q000382:microbiology*; D002939:Ciprofloxacin / Q000494:pharmacology; D003091:Colistin / Q000494:pharmacology; D004926:Escherichia coli / Q000187:drug effects / Q000201:enzymology; D016905:Gram-Negative Bacterial Infections / Q000150:complications / Q000382:microbiology*; D006801:Humans; D015378:Imipenem / Q000494:pharmacology; D007709:Klebsiella / Q000187:drug effects / Q000201:enzymology; D008826:Microbial Sensitivity Tests; D011549:Pseudomonas / Q000187:drug effects; D012189:Retrospective Studies; D065093:beta-Lactamase Inhibitors / Q000494:pharmacology*; D001618:beta-Lactamases / Q000378:metabolism*; D047090:beta-Lactams / Q000494:pharmacology*
chemical_list: D000900:Anti-Bacterial Agents; D065093:beta-Lactamase Inhibitors; D047090:beta-Lactams; D002939:Ciprofloxacin; D015378:Imipenem; D001618:beta-Lactamases; D003091:Colistin