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

doi:10.1186/s40635-018-0185-2

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

Research output: Contribution to journal › Article › peer-review

6 Citations (Scopus)

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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-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 language	English
Article number	19
Pages (from-to)	1-7
Number of pages	7
Journal	Intensive Care Medicine Experimental
Volume	6
DOIs	https://doi.org/10.1186/s40635-018-0185-2
Publication status	Published - 27 Jul 2018

Bibliographical note

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.

Keywords

INTENSIVE-CARE-UNIT
ANTIMICROBIAL RESISTANCE
MICROBIOTA
GUT

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10.1186/s40635-018-0185-2

Publisher version (open access)Final published version, 772 KBLicence: CC BY

Cite this

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title = "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-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.",

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doi = "10.1186/s40635-018-0185-2",

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AU - Venturini, Carola

AU - Ginn, Andrew N.

AU - Wilson, Brooke E.

AU - Tsafnat, Guy

AU - Paulsen, Ian

AU - Partridge, Sally R.

AU - Iredell, Jonathan R.

N1 - 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.

PY - 2018/7/27

Y1 - 2018/7/27

N2 - 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.

AB - 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.

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KW - ANTIMICROBIAL RESISTANCE

KW - MICROBIOTA

KW - GUT

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

Abstract

Bibliographical note

Keywords

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