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PubMed1978

Enterotoxin-producing bacteria stools from Swedish United Nations soldiers in Cyprus.

A study was designed to establish the role of heat-labile enterotoxin producing Escherichia coli and other intestinal pathogens in diarrhoeal disease in Swedish soldiers of the United Nations' Force in Cyprus. Before leaving Sweden for Cyprus, no enteropathogens were isolated from the soldiers. The study was performed from October 1975 through January 1976 and in August 1976. Enterotoxigenic strains of E. coli, Citrobacter freundii, Enterobacter cloacae and Klebsiella pneumoniae were the intestinal pathogens most frequently isolated from the cases of diarrhoea. Such strains were found in 14 of 79 diarrhoeal cases (18%) but also in 6 of 66 (9%) of next-bed-fellow controls and in 7 of 139 (5%) of healthy Cypriotic civilians. Few other pathogens were identified in the soldiers, but 9 of 139 (6%) of the Cypriots were carriers of cysts of Giardia lamblia. The results indicate that enterotoxigenic bacteria were probably the most important cause of diarrhoea of those agents identified among the Swedish UN soldiers on Cyprus. Several soldiers were colonized with these strains without contracting diarrhoea.

Bacteria↗
PubMedDate not supplied

Combination effect of SCE-2787 and cefepime with aminoglycosides on nosocomial gram-negative bacteria.

The in vitro activity of cefepime and SCE-2787, two new parenteral cephalosporins, and the combination effect with tobramycin and gentamicin against nosocomial gram-negative rods was studied using checkerboard agar dilution technique. Cefepime showed excellent in-vitro activity against Klebsiella pneumoniae, Enterobacter cloacae, Serratia marcescens and Proteus vulgaris (MIC90 0.03-0.125 mg/l) and good to moderate activity against Acinetobacter anitratus, Pseudomonas aeruginosa and Pseudomonas cepacia (MIC90 4-16 mg/l). SCE-2787 had an excellent activity against Citrobacter spp. (MIC90 0.125 mg/l) and a very good activity against A. anitratus, P. aeruginosa and P. vulgaris (MIC90 1-2 mg/l). Pseudomonas maltophilia was not inhibited at therapeutically achievable concentrations (MIC90 64 mg/l). On average, 14-28% of the strains were inhibited by synergistic SCE-2787 aminoglycoside-combinations, whereas only 8.6% were inhibited by a synergistic effect of the combination with cefepime and gentamicin. No antagonism occurred with any of the combinations.

Anti-Bacterial Agents↗
PubMedDate not supplied

Pathogenesis of Escherichia coli cystitis and pyelonephritis: apparent lack of significance of bacterial motility and chemotaxis towards human urine.

All 45 microscopically motile urinary isolates tested here (37 Escherichia coli, two Enterobacter cloacae, two Citrobacter freundii, three Proteus mirabilis and one Proteus morganii) were strongly attracted to fresh human urine in a capillary chemotaxis assay. This observation suggested that urine taxis of gram-negative bacteria promotes their invasion of the human lower urinary tract and their ascension to the kidney(s). However, the incidence of motile isolates and their activity in urine taxis assays were similar for fecal E. coli isolates, for isolates from patients with recurrent cystitis and from patients with presumed pyelonephritis (E. coli blood isolates with concomitant E. coli bacteriuria). Thus, the present study of E. coli did not support the hypothesis that bacterial motility is a virulence factor in urinary tract infection.

Bacteriuria↗
PubMed1985

Clinical evaluation of the effect of cefotaxime in senile pneumonia caused by gram-positive and gram-negative bacteria.

66 patients with predominantly community-acquired pneumonia were treated with cefotaxime. The group consisted of 45 males and 21 females, aged 56 to 90 years, 43 of the patients belonging to the age groups 65-80 years. Streptococcus pneumoniae was isolated in 21 of the 34 patients with gram-positive pneumonia, Staphylococcus aureus in six, Staphylococcus epidermidis in five and Streptococcus faecalis in two. Klebsiella pneumoniae was the predominant pathogen in gram-negative pneumonia (eight patients), followed by Enterobacter (n = 6), Pseudomonas aeruginosa (n = 5), Haemophilus influenzae (n = 4), Escherichia coli (n = 3), Serratia marcescens and Citrobacter (two cases each). The in vitro activity of cefotaxime against the isolates was compared to the activity of other beta-lactam antibiotics. Characteristically, the classical signs and symptoms of pneumonia were absent or discrete in some of the elderly patients. There was a delayed clearance of pulmonary infiltrates. 55 of 66 patients responded to cefotaxime within four weeks of treatment; the symptoms were aggravated or remained unchanged in seven patients. Patients with a delayed clinical response displayed decreased peripheral lymphocyte counts and T cell functions in PHA stimulation tests, as well as low immunoglobulin levels. A combination of cefotaxime and gamma-venin cleared the symptoms in some of these patients.

Aged↗
PubMed1985

The influence of third-generation cephalosporins on the aerobic intestinal flora.

The influence of three third-generation cephalosporins with varying degrees of biliary excretion on the aerobic flora was investigated. The faecal flora prior to therapy with one of these substances consisted mainly of anaerobic bacilli. Escherichia coli was present in concentrations of 10(9) organisms/g stool. Candida albicans and enterococci were observed in concentrations of 10(5) - 10(6) organisms/g stool. Within 24 hours after the administration of ceftriaxone and cefoperazone, the gram-negative aerobic flora was completely eradicated. C. albicans and enterococci increased to 10(9) organisms/g stool. Between the third and tenth days (mean 6.7 days) of therapy Pseudomonas aeruginosa, Enterobacter and Citrobacter in this order of frequency reappeared in the faecal flora with complete resistance to all betalactam antibiotics. C. albicans and enterococci decreased to 10(7) organisms/g stool. The anaerobic flora was largely unaltered. In contrast, cefotaxime had only a moderate influence on the aerobic faecal flora. Concentrations of gram-negative organisms decreased to 5 X 10(7) organisms/g stool during the first five days of therapy; the concomitant increase in C. albicans and enterococci was approximately 1 log 10. No alterations in the susceptibility pattern were observed. We would like to emphasize that substantial alterations of the faecal flora and the susceptibility pattern of antibiotics may accompany the use of antimicrobial agents, particularly those with a high degree of biliary elimination.

Bacteria, Aerobic↗
PubMed1990

[Antibacterial activity and beta-lactamase stability of eleven oral cephalosporins].

Oral cephalosporins (cefixime, cefdinir, cefetamet, ceftibuten, cefpodoxime, loracarbef, cefprozil, cefuroxime, cefaclor, cefadroxil and BAY 3522) were compared by their antibacterial profile including stability against new beta-lactamases. Both activity and antibacterial spectrum of compounds structurally related to third generation parenteral cephalosporins (of the oximino class) were superior to established compounds. Activity against staphylococci was found to be highest for cefdinir, cefprozil and BAY 3522. Cefetamet, ceftibuten and cefixime demonstrate no clinically meaningful antistaphylococcal activity while the other compounds investigated demonstrate intermediate activity. The antibacterial spectrum was broadest for cefdinir and cefpodoxime. New oral cephalosporins are equally inactive as established compounds against Enterobacter spp., Morganella, Listeria, Pseudomonas and Acinetobacter spp., methicillin-resistant staphylococci, Enterococcus spp., penicillin-resistant pneumococci and anaerobes. New extended broad-spectrum betalactamases (TEM-3, TEM-5, TEM-6, TEM-7, SHV-2, SHV-3, SHV-4, SHV-5, CMY-1, CMY-2, and CTX-M) are active against the majority of oral cephalosporins. Ceftibuten, cefetamet, cefixime and cefdinir were stable against some of these enzymes even to a higher extent than parenteral cephalosporins. New oral cephalosporins should improve the therapeutic perspectives of oral cephalosporins due to their higher activity against pathogens marginally susceptible to established compounds (higher multiplicity of maximum plasma concentrations over MICs of the pathogens) and furthermore by including in their spectrum organisms resistant to established absorbable cephalosporins (e.g. Proteus spp., Providencia spp., Citrobacter spp., and Serratia spp.).

Administration, Oral↗
PubMedDate not supplied

Antibacterial activity of cefpodoxime in comparison with cefixime, cefdinir, cefetamet, ceftibuten, loracarbef, cefprozil, BAY 3522, cefuroxime, cefaclor and cefadroxil.

The new oral cephalosporins cefpodoxime, cefixime, cefdinir, cefetamet and ceftibuten demonstrate enhanced activity against Enterobacteriaceae susceptible to the established compounds as well (e.g. cefuroxime, cefaclor, cefadroxil). In addition, cefpodoxime, cefixime, cefdinir, cefetamet and ceftibuten include in their spectrum species hitherto resistant to oral cephalosporins (Proteus vulgaris, Providencia spp., Yersinia enterocolitica). Besides, the majority of these compounds demonstrate relevant activity (MIC50 equal to or below 2 mg/l) against Enterobacter spp., Citrobacter freundii, Serratia spp. and Morganella morganii. Ceftibuten is the most potent oral cephalosporin against most of the Enterobacteriaceae. Non-fermentative bacilli (Acinetobacter spp., Pseudomonas spp.) remain completely resistant to oral cephalosporins (except some Acinetobacter species against cefdinir and Pseudomonas cepacia against ceftibuten). Antistaphylococcal activity for oral cephalosporins is highest for cefdinir followed by BAY 3522, cefprozil, cefuroxime and cefpodoxime. Loracarbef, cefaclor and cefadroxil are about equally active, while the other compounds are only weakly active (cefixime) or inactive (cefetamet, ceftibuten). Enterococci are insensitive to new generation oral cephalosporins as they have been to established compounds. The most active oral cephalosporins against hemolytic streptococci are cefdinir and cefprozil. Streptococcus pneumoniae, Streptococcus milleri and Streptococcus mitior are most susceptible to cefpodoxime, cefdinir, cefuroxime and BAY 3522. Penicillin resistant pneumococci have to be regarded as resistant to all oral cephalosporins. Fastidious pathogens like Haemophilus spp., Moraxella catarrhalis and Neisseria gonorrhoeae are more susceptible to cefpodoxime, cefixime, cefdinir, cefetamet and ceftibuten than to the other oral cephalosporins. The activity of oral cephalosporins is only weak against Listeria spp., Helicobacter pylori and anaerobic pathogens (except BAY 3522). Bordetella pertussis remains resistant to all absorbable cephalosporins. Progress in antibacterial activity of oral cephalosporins was mainly achieved by cefpodoxime, cefixime, cefdinir, cefetamet and ceftibuten against Enterobacteriaceae and the fastidious pathogens and against staphylococci and the nonenterococcal streptococci by cefdinir, BAY 3522, cefprozil and cefpodoxime.

Bacteria↗
PubMedDate not supplied

In vitro activity of cefpodoxime and ten other cephalosporins against gram-positive cocci, Enterobacteriaceae and Pseudomonas aeruginosa, including beta-lactamase producers.

Cefpodoxime, the deesterified part of the orally available cefpodoxime proxetil, is active against most Enterobacteriaceae with MIC50 of 0.06 to 2 mg/l. Only Enterobacter cloacae and Citrobacter freundii strains show MIC50 of 4 mg/l. Coagulase negative staphylococci have a MIC50 of 2, while Staphylococcus aureus strains have a MIC of 4 mg/l. In comparison to other orally available cephalosporins cefpodoxime is slightly less active than cefixime and cefotiam against gram-negative bacteria but more active than cefuroxime, cefaclor, and cephalexin. Against staphylococci the activity of cefpodoxime is comparable to that of cefotiam and cefuroxime and superior to cefaclor and cephalexin, while cefixime does not have sufficient activity against these species. Like all cephalosporins cefpodoxime has no activity against enterococci.

Bacteria↗
PubMedDate not supplied

Cefpodoxime: comparative antibacterial activity, influence of growth conditions, and bactericidal activity.

The antimicrobial activity of cefpodoxime, the active metabolite of the new cephalosporin ester cefpodoxime proxetil, in comparison to cefixime, cefotiam, cefuroxime, and cefotaxime was determined against a broad spectrum of freshly isolated gram-positive and gram-negative bacterial strains. Cefpodoxime was demonstrated to be inhibitory at concentrations of less than or equal to 1 mg/l against 90% of strains of Moraxella catarrhalis, Haemophilus influenzae, Escherichia coli (beta-lactamase- negative strains), Klebsiella spp., Serratia spp., Proteus mirabilis, Proteus vulgaris, Providencia spp., and Salmonella spp. This antimicrobial activity of cefpodoxime was generally superior to that of cefuroxime and similar to that of cefixime. Cefpodoxime was active at less than or equal to 1 mg/l against 50% of the members of beta-lactamase-producing Escherichia coli, Enterobacter cloacae, Enterobacter aerogenes, Citrobacter spp., and Morganella morganii. Cefpodoxime proved to be highly inhibitory against group A, B, and G streptococci and Streptococcus pneumoniae (MIC90 less than 0.015 mg/l). The MICs of cefpodoxime and those of the other cephalosporins were less than 2 mg/l for greater than or equal to 90% of the strains of Staphylococcus aureus and Staphylococcus epidermidis, with the exception of cefixime which had no activity with MICs below 8 mg/l against these bacteria. Pseudomonas spp., Acinetobacter spp., and Enterococcus spp. were resistant to cefpodoxime. The antibacterial activity of cefpodoxime was only to a minor degree influenced by different growth conditions with the exception of high inoculum sizes against some beta-lactamase producing strains of gram-negative bacilli.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Infective Agents, Urinary↗
PubMed1991

In vitro activity and stability against novel beta-lactamases of investigational beta-lactams (cefepime, cefpirome, flomoxef, SCE2787 and piperacillin plus tazobactam) in comparison with established compounds (cefotaxime, latamoxef and piperacillin).

The therapeutic perspectives of flomoxef, SCE 2787, cefpirome, cefepime, latamoxef, cefotaxime and of piperacillin plus tazobactam were comparatively evaluated by their in vitro activity against 1119 clinical isolates of 83 bacterial species. Escherichia coli, Klebsiella spp. Enterobacter sakazakii, Proteus spp. and Shigella spp. were about equally susceptible to the cephalosporins (MIC90: 0.06 to 0.5 mg/l), while the MIC90 for piperacillin plus tazobactam was between 2 and 16 mg/l. Enterobacter cloacae, Enterobacter aerogenes and Serratia spp. were most susceptible to SCE 2787, cefpirome and cefepime (MIC90: 0.06 to 2 mg/l) followed by latamoxef, cefotaxime, flomoxef and piperacillin plus tazobactam. For Citrobacter spp., Providencia spp. and Yersinia enterocolitica MIC90 were between 0.06 and 0.5 mg/l. Flomoxef was between 2 to 4 log2 less active against these species but more active than piperacillin plus tazobactam (MIC90: 2 and 8 mg/l). Morganella morganii and Hafnia alvei were most susceptible to cefepime, cefpirome and latamoxef (MIC90: 0.13 to 0.5 mg/l) while cefotaxime (MIC90: 8 mg/l) and piperacillin plus tazobactam (MIC90: 8 and greater than 64 mg/l) were the least active compounds. SCE 2787, cefepime and cefpirome were the most potent beta-lactams against the majority of the 13 species of non-fermentative bacilli (NFB) investigated (MIC90: 0.5 to 16 mg/l). The oxacephems were the least active compounds against NFB. Cefepime was the most active of the compounds included against Pseudomonas aeruginosa (MIC90: 16 mg/l). Haemophilus spp., Neisseria gonorrhoeae and Bordetella pertussis were most susceptible to cefotaxime (MIC90: 0.03 to 0.06 mg/l). Latamoxef had the lowest activity of all compounds against gram-positive cocci. Flomoxef was the most active compound against penicillinase producing Staphylococcus aureus and about equally active as the other betalactams against methicillin susceptible staphylococci of other staphylococcal species.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Bacterial Agents↗
PubMed1987

[Comparative in vitro study of the antimicrobial activity of ceftazidime against clinical isolates].

The antimicrobial activity of ceftazidime was tested against 1482 gram-negative and 1216 gram-positive strains isolated from fresh clinical specimens and compared with generally used antibiotics including other third generation cephalosporins and broad spectrum penicillins. Minimal inhibitory concentrations were determined in a broth dilution test on microtiter plates. In the group of the gram-negative bacteria ceftazidime was the most active of the antimicrobial agents tested with an MIC of 0.5 mg/l (MIC90) for most of the isolates. Ceftazidime exhibited a broad spectrum of activity against gram-negative pathogenic bacteria including Enterobacteriaceae (Escherichia coli, Klebsiella spp., Proteus spp. Enterobacter spp., Citrobacter spp., Serratia spp.) including frequently resistant strains of Pseudomonas aeruginosa, Acinetobacter spp. and Alcaligenes faecalis. The activity against P. aeruginosa is the most remarkable property of the agent. Ceftazidime is less effective against gram-positive compared to gram-negative bacteria. No inhibitory action can be observed against Streptococcus faecalis.

Anti-Bacterial Agents↗
PubMed1979

[Antibacterial activity of cefotaxim in comparison with seven cephalosporins].

The antibacterial activity of cefotaxim and seven cephalosporins was determined in 1,112 fresh isolates using the microdilution technique. All of the cephalosporins tested were ineffective against enterococci. Cefalotin was the most effective agent against Staphylococcus aureus. Cefaclor was superior to cephalexin against Escherichia coli and Proteus mirabilis, and thus inhibited 20% more Enterobacteriaceae. Cefazolin was as effective as cefamandole against E. coli. Cefuroxime and cefoxitin were almost equally effective against E. coli, Klebsiella and P. mirabilis; more than 95% of the strains were sensitive. Cefuroxime and also cefamandole were much more effective than cefoxitin against Citrobacter and Enterobacter. Cefoxitin on the other hand was superior against Serratia and indol-positive Proteus species. Cefotaxim was by far the most active cephalosporin against Enterobacteriaceae, only 2% of the strains being resistant. More than 90% of the strains of E. coli, Klebsiella, P. mirabilis and Serratia were sensitive to 1 mg/l, the lowest degree of activity being displayed against Enterobacter; 82% of the strains were inhibited by 16 mg/l. Cefotaxim was the only cephalosporin which showed appreciable activity against Pseudomonas.

Bacteria↗
PubMedDate not supplied

[Microbiological studies with the new penicillin BRL 17421 (temocillin)].

In vitro Evaluation of BRL 17421 (Temocillin), a New Penicillin. The in vitro antibacterial activity of BRL 17421 (temocillin), a new penicillin, was determined in quantitative serial broth dilution tests and was compared to that of mezlocillin, piperacillin, cefazolin and cefotaxime against 751 clinical isolates of the Enterobacteriaceae family. In addition, the sensitivity of 211 mezlocillin-resistant gram-negative rods to BRL 17421 was also determined. Temocillin exhibited a high level of antibacterial activity against various bacterial species of the Enterobacteriaceae family, including isolates resistant to mezlocillin. The 90% MICs against Escherichia coli, Klebsiella pneumoniae, Citrobacter freundii, Enterobacter cloacae, Salmonella spp., Yersinia spp. and indole-negative and indole-positive Proteus strains ranged from 0.5 mg/l to 16 mg/l. Concentrations of 16 mg/l were required to inhibit 80% of the Serratia marcescens strains; some isolates were resistant. No significant difference between MIC and MBC values was observed.

Cefazolin↗
PubMed1978

Bacterial contamination of pulmonary artery catheters.

The catheter tips of 152 patients, who were haemodynamically supervised by pulmonary artery monitoring or continuous cardiac output determination, were bacteriologically examined. 106 cultures remained sterile, 21 cultures revealed a growth of non pathogenic organisms. Staphylococcus aureus was cultured 15 times, pseudomonas aeruginosa 4 times, Citrobacter as well as Escherichia coli twice, and Klebsiella and Enterobacter once each. There was no statistically significant connection between dwelling period and contamination. Also diabetes mellitus or corticoid medication in high dosage had no significant influence on contamination rate.

Bacteria↗
PubMed1997

Molecular epidemiology of an outbreak due to extended-spectrum beta-lactamase-producing enterobacteria in a French hospital.

Between June 1992 and June 1993, 128 extended-spectrum beta-lactamase-producing enterobacteria (123 Klebsiella pneumoniae, 3 Escherichia coli, 1 Enterobacter aerogenes, and 1 Citrobacter diversus) were collected in a French university hospital. These isolates were recovered mainly from patients hospitalized in intensive care and neurosurgery units. The 128 strains were divided into 14 antibiotypes (ATBs; ATB1 to ATB14); 102 of 103 nonredundant isolates were shown to produce an SHV-4-related extended-spectrum beta-lactamase (pl 7.8, hybridization with a blaSHV probe); the remaining strain (Kp 2108) produced a TEM-3-related extended-spectrum beta-lactamase (pl 6.3, hybridization with a blaTEM probe). For representative isolates, five plasmid profiles (Pl to Pll-4), eight ribotypes (E1 to E8), and seven arbitrarily primed polymerase chain reaction profiles (A1 to A7) were obtained. The results suggest the spread of an epidemic strain of Klebsiella pneumoniae (E1, A1, Pl, various ATBs) from an intensive care unit throughout the hospital. Another epidemic strain (E2, A2, pl, ATB4) was confined to the neurosurgery unit. Other extended-spectrum beta-lactamase-producing Klebsiella pneumoniae of ribotypes distinct from E1 or E2 might result from the spread of an epidemic plasmid, such as reported for isolates of other enterobacterial species. Conversely, they might represent imported cases, such as the strain Kp 2108, which produced a TEM-3-related beta-lactamase.

Cross Infection↗
PubMed1992

In vitro activity of cefodizime.

Cefodizime is a bactericidal cephem with the typical broad spectrum activity of an aminothiazolyl cephalosporin, including both gram-positive and gram-negative bacteria: its MIC90 is 0.125 mg/l for Streptococcus pneumoniae, Streptococcus pyogenes and other streptococci; and 0.05 mg/l for Haemophilus spp., Neisseria meningitidis, Neisseria gonorrhoeae and Moraxella catarrhalis; while beta-lactamase positive strains of M. catarrhalis require 1 mg/l. Less than 1 mg/l is needed for Escherichia coli, Klebsiella spp., Proteus spp. and Shigella spp. The MIC90 is 4 mg/l for methicillin-sensitive Staphylococcus aureus, Morganella morganii, Providencia spp. and most strains of Serratia marcescens, Citrobacter spp. and Enterobacter spp. Staphylococcus epidermidis, Enterococcus faecalis and most strains of Pseudomonas spp. and Acinetobacter spp. are considered cefodizime-resistant. Cefodizime is unaffected by plasmid-mediated beta-lactamases, but it is hydrolyzed by some chromosomally mediated enzymes, thus resembling other third-generation cephalosporins. Cefodizime has high affinity for PBP 3 and PBP IA and IB (Escherichia coli); in S. aureus it shows the highest affinity for PBP 1.

Bacteria↗
PubMed1982

Enteropathogenicity: recent developments.

Recent studies have added important new information to our understanding of the pathogenesis and ethiology of diarrheal disease. Vibrio cholerae produces a heat-labile enterotoxin, affecting cyclic AMP. A very similar heat-labile enterotoxin is produced also by certain strains of Escherichia coli, as well as by Citrobacter, Klebsiella, and Aeromonas. E. coli may also produce a heat-stable enterotoxin, stimulating guanylate cyclase activity. In order to produce the pathologic effects, E. coli first attaches to epithelial cells of the intestinal tract by means of pili or surface antigens. Enterotoxin can be demonstrated by both in vivo and in vitro tests, but none are yet suitable for routine diagnostic laboratories. A third mechanism whereby E. coli causes diarrheal disease consists of enteroinvasiveness. Campylobacter, Yersinia, and Clostridium difficile have been added to the list of enteric pathogens of man.

Animals↗
PubMed1994

Evolution of beta-lactamase inhibitors.

beta-Lactamases present the greatest single challenge to beta-lactam antibiotics, including piperacillin. beta-Lactamase-mediated resistance to supposedly beta-lactamase stable agents such as second- and third-generation cephalosporins is now emerging and inhibitor combinations provide an alternative strategy to overcome this problem. The success of this strategy depends on 1) how efficiently the inhibitor inhibits important beta-lactamases, 2) on how much beta-lactamase the bacteria produce, 3) on the drug that is to be protected, 4) on the permeability and intrinsic susceptibility of the organisms and 5) on the conditions, notably the pH. Tazobactam inhibits most of the clinically important beta-lactamases that give piperacillin resistance, except for the Class I types. Piperacillin itself is a relatively easy drug to protect, particularly against the TEM-type enzymes. The result is that tazobactam greatly extends the activity of piperacillin, notably against enterobacteria, but also against staphylococci and anaerobes. The survey confirmed the very broad spectrum of activity of piperacillin/tazobactam. Resistance occurred in about 17% of the Enterobacter, Citrobacter, Serratia group, where we believe it to have been caused by derepressed Class I enzymes since these strains were cross-resistant to third-generation cephalosporins. Otherwise, resistance was largely confined to such organisms as E. faecium and methicillin-resistant staphylococci, which have piperacillin insensitive penicillin-binding proteins. Finally, some question remains on the antistaphylococcal activity of piperacillin/tazobactam, where MIC tests gave a more favorable impression than disc tests. Nevertheless, early clinical results against staphylococcal infection appear good, with a response rate of nearly 90% [15].

Anti-Bacterial Agents↗