Ecological effects of cefepime use during antibiotic cycling on the Gram-negative enteric flora of ICU patients
Abstract This study examines the impact of cefepime and APP-β (antipseudomonal penicillin/ β-lactamase inhibitor combinations) on Gram-negative bacterial colonization and resistance in two Australian ICUs. While resistance did not cumulatively increase, cefepime (but not APP-β treatment) was associa...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2018-07-01
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| Series: | Intensive Care Medicine Experimental |
| Online Access: | http://link.springer.com/article/10.1186/s40635-018-0185-2 |
| _version_ | 1818960562872123392 |
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| author | Carola Venturini Andrew N. Ginn Brooke E. Wilson Guy Tsafnat Ian Paulsen Sally R. Partridge Jonathan R. Iredell |
| author_facet | Carola Venturini Andrew N. Ginn Brooke E. Wilson Guy Tsafnat Ian Paulsen Sally R. Partridge Jonathan R. Iredell |
| author_sort | Carola Venturini |
| collection | DOAJ |
| description | Abstract This study examines the impact of cefepime and APP-β (antipseudomonal penicillin/ β-lactamase inhibitor combinations) on Gram-negative bacterial colonization and resistance in two Australian ICUs. While resistance did not cumulatively increase, cefepime (but not APP-β treatment) was associated with acquisition of antibiotic resistant Enterobacteriaceae, consistent with an ecological effect. Analysis of the resident gut E. coli population in a subset of patients showed an increase in markers of horizontal gene transfer after cefepime exposure that helps explain the increase in APP-β resistance and reminds us that unmeasured impacts on the microbiome are key outcome determinants that need to be fully explored. |
| first_indexed | 2024-12-20T11:59:31Z |
| format | Article |
| id | doaj.art-ae277a722a524a168066e54b7f45db00 |
| institution | Directory Open Access Journal |
| issn | 2197-425X |
| language | English |
| last_indexed | 2024-12-20T11:59:31Z |
| publishDate | 2018-07-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Intensive Care Medicine Experimental |
| spelling | doaj.art-ae277a722a524a168066e54b7f45db002022-12-21T19:41:35ZengSpringerOpenIntensive Care Medicine Experimental2197-425X2018-07-01611710.1186/s40635-018-0185-2Ecological effects of cefepime use during antibiotic cycling on the Gram-negative enteric flora of ICU patientsCarola Venturini0Andrew N. Ginn1Brooke E. Wilson2Guy Tsafnat3Ian Paulsen4Sally R. Partridge5Jonathan R. Iredell6Centre for Infectious Diseases and Microbiology, The Westmead Institute for Medical Research, The University of Sydney and Westmead HospitalCentre for Infectious Diseases and Microbiology, The Westmead Institute for Medical Research, The University of Sydney and Westmead HospitalCentre for Infectious Diseases and Microbiology, The Westmead Institute for Medical Research, The University of Sydney and Westmead HospitalAustralian Institute of Health Innovation, Centre for Health Informatics, Macquarie UniversityFaculty of Science and Engineering, Department of Chemistry and Biomolecular Sciences, Macquarie UniversityCentre for Infectious Diseases and Microbiology, The Westmead Institute for Medical Research, The University of Sydney and Westmead HospitalCentre for Infectious Diseases and Microbiology, The Westmead Institute for Medical Research, The University of Sydney and Westmead HospitalAbstract This study examines the impact of cefepime and APP-β (antipseudomonal penicillin/ β-lactamase inhibitor combinations) on Gram-negative bacterial colonization and resistance in two Australian ICUs. While resistance did not cumulatively increase, cefepime (but not APP-β treatment) was associated with acquisition of antibiotic resistant Enterobacteriaceae, consistent with an ecological effect. Analysis of the resident gut E. coli population in a subset of patients showed an increase in markers of horizontal gene transfer after cefepime exposure that helps explain the increase in APP-β resistance and reminds us that unmeasured impacts on the microbiome are key outcome determinants that need to be fully explored.http://link.springer.com/article/10.1186/s40635-018-0185-2 |
| spellingShingle | Carola Venturini Andrew N. Ginn Brooke E. Wilson Guy Tsafnat Ian Paulsen Sally R. Partridge Jonathan R. Iredell Ecological effects of cefepime use during antibiotic cycling on the Gram-negative enteric flora of ICU patients Intensive Care Medicine Experimental |
| title | Ecological effects of cefepime use during antibiotic cycling on the Gram-negative enteric flora of ICU patients |
| title_full | Ecological effects of cefepime use during antibiotic cycling on the Gram-negative enteric flora of ICU patients |
| title_fullStr | Ecological effects of cefepime use during antibiotic cycling on the Gram-negative enteric flora of ICU patients |
| title_full_unstemmed | Ecological effects of cefepime use during antibiotic cycling on the Gram-negative enteric flora of ICU patients |
| title_short | Ecological effects of cefepime use during antibiotic cycling on the Gram-negative enteric flora of ICU patients |
| title_sort | ecological effects of cefepime use during antibiotic cycling on the gram negative enteric flora of icu patients |
| url | http://link.springer.com/article/10.1186/s40635-018-0185-2 |
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