Ecological effects of cefepime use during antibiotic cycling on the Gram-negative enteric flora of ICU patients

Carola Venturini, Andrew N. Ginn, Brooke E. Wilson, Guy Tsafnat, Ian Paulsen, Sally R. Partridge, Jonathan R. Iredell*

*Corresponding author for this work

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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-βtreatment) 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-βresistance and reminds us that unmeasured impacts on the microbiome are key outcome determinants that need to be fully explored.

Original languageEnglish
Article number19
Pages (from-to)1-7
Number of pages7
JournalIntensive Care Medicine Experimental
Publication statusPublished - 27 Jul 2018

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Copyright the Author(s) 2018. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


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