title: What does the susceptible-dose dependent interpretive category for cefepime in ESBL-producing bacteria?
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, blaSHVand blaCTXgenes 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.
authors.affiliation: a Departamento de Ciências Básicas da Saúde , Universidade Estadual de Maringá , Maringá , Brazil.
authors.forename: Thatiany Cevallos
authors.initials: TC
authors.lastname: Menegucci
authors.affiliation: a Departamento de Ciências Básicas da Saúde , Universidade Estadual de Maringá , Maringá , Brazil.
authors.forename: Marina de Souza
authors.initials: MS
authors.lastname: Bastos
authors.affiliation: a Departamento de Ciências Básicas da Saúde , Universidade Estadual de Maringá , Maringá , Brazil.
authors.forename: Giselle Fukita
authors.initials: GF
authors.lastname: Viana
authors.affiliation: a Departamento de Ciências Básicas da Saúde , Universidade Estadual de Maringá , Maringá , Brazil.
authors.forename: Rafael Renato Brondani
authors.initials: RRB
authors.lastname: Moreira
authors.affiliation: a Departamento de Ciências Básicas da Saúde , Universidade Estadual de Maringá , Maringá , Brazil.
authors.forename: Lourdes Botelho
authors.initials: LB
authors.lastname: Garcia
authors.affiliation: a Departamento de Ciências Básicas da Saúde , Universidade Estadual de Maringá , Maringá , Brazil.
authors.forename: Celso Luiz
authors.initials: CL
authors.lastname: Cardoso
authors.affiliation: a Departamento de Ciências Básicas da Saúde , Universidade Estadual de Maringá , Maringá , Brazil.
authors.forename: Maria Cristina Bronharo
authors.initials: MCB
authors.lastname: Tognim
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000378:metabolism / Q000494:pharmacology* / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000235:genetics / Q000378:metabolism*; D001938:Brazil; D000077723:Cefepime; D002511:Cephalosporins / Q000009:adverse effects / Q000378:metabolism / Q000494:pharmacology* / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D024901:Drug Resistance, Multiple, Bacterial; D016972:Enterobacter cloacae / Q000145:classification / Q000187:drug effects* / Q000201:enzymology / Q000254:growth & development; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000382:microbiology; D005798:Genes, Bacterial; D006801:Humans; D008658:Inactivation, Metabolic; D007362:Intensive Care Units; D007710:Klebsiella Infections / Q000188:drug therapy / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000145:classification / Q000187:drug effects* / Q000201:enzymology / Q000254:growth & development; D008826:Microbial Sensitivity Tests; D058889:Molecular Typing; D017410:Practice Guidelines as Topic; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D002511:Cephalosporins; D000077723:Cefepime; D001618:beta-Lactamases
keywords: Cefepime; Enterobacter cloacae; Extended-spectrum β-lactamase; Klebsiella pneumoniae; Minimum inhibitory concentration; Susceptible-dose dependent