A comparative in vitro sensitivity study of “cefepime-tazobactam” and other antibiotics against Gram-negative isolates from intensive care unit

Abstract

Objectives: The major health problem today includes the emergence of multidrug-resistant (MDR) bacteria, especially extended-spectrum β lactamase, carbapenemases, and Amp C-producing Gram-negative bacilli (GNB). Our study is aimed to recognize the in vitro susceptibility pattern of cefepime/tazobactam compared to other antibiotics used against GNB in an intensive care unit (ICU) setting. Materials and Methods: We conducted a prospective observational research comprising all GNB isolated from clinical samples of patients admitted to the ICU throughout the study period from January 2021 to December 2021. All of the isolates were analyzed using “ Matrix Assisted Laser Desorption/ionization - time of flight - Mass spectrometry assay (MALDI-TOF-MS)” for identification and the Kirby-Bauer disc diffusion technique to test for susceptibility. Cefepime-tazobactam was tested by E-test (Hi-Media, Mumbai) method. The minimum inhibitory concentrations (MIC) of cefepime (as in Clinical Laboratory Standards Institute, 2021) has been utilized to elucidate the sensitivity of cefepime-tazobactam, as no criteria for cefepime-tazobactam is available. Statistical Analysis: All statistical analysis was performed using the software program IBM Statistical Package for Social Sciences (SPSS) Statistics version 20.0, with P < 0.05 considered statistically significant. Results: We included a total of 480 GNB isolated from blood, pus, body fluids, endotracheal aspirates (ETA), and sputum samples. The most common microorganism tested for susceptibility to cefepime-tazobactam was Klebsiella pneumoniae (182/480, 37.92%) followed by Acinetobacter baumannii (135/480, 28.12%), and Pseudomonas aeruginosa (94/480, 19.58%). K. pneumoniae and Enterobacter aerogenes were most resistant to all the antibiotics tested against them. K. pneumoniae was most resistant to meropenem (41/182, 22.53%), followed by imipenem (42/182, 23.08%) and cefoperazone-sulbactam (49/182, 26.92%) and was predominantly found susceptible to cefepime-tazobactam (122/182, 67.04%). Conclusions: Cefoperazone-tazobactam is a new “β-lactam/β-lactamase combination” found effective in the in vitro analysis of drug-resistant isolates of GNB.