Mt. Lewis et al., In vitro evaluation of cefepime and other broad-spectrum beta-lactams against bacteria from Indonesian medical centers, DIAG MICR I, 35(4), 1999, pp. 285-290
The in vitro activity of cefepime and six other broad-spectrum beta-lactams
(cefpirome, ceftazidime, ceftriaxone, imipenem, piperacillin/tazobactam (4
mu g/mL fixed concentration, and oxacillin was evaluated against 191 isola
tes of clinical bacteria from Indonesia. Susceptibility testing was perform
ed using Etest (AB BIODISK, Solna, Sweden) methodology. Isolates from 10 sp
ecies groups were selected for analysis: Escherichia coli, Klebsiella spp.,
Enterobacter spp., indole-positive Proteae, Serratia spp., Acinetobacter s
pp., Pseudomonas aeruginosa, and oxacillin-susceptible staphylococci. The o
verall rank order of spectrum of activity ions (% resistant): imipenem (2.2
%) > cefepime (7.3%) > piperacillin/tazobactam > cefpirome > ceftazidime >
ceftriaxone (26.2%). The "fourth-generation" cephalosporins, cefepime and c
efpirome, displayed greater activity compared with the "third-generation" c
ephalosporins, ceftazidime, and ceftriaxone, against the 60 E. coli and Kle
bsiella spp. (30 each) isolates. Phenotypic extended spectrum beta-lactamas
e occurrence rates among the E. coil and Klebsiella spp. were 23.3 and 33.3
%, respectively. Imipenem, cefepime, and cefpirome inhibited 95.7% of the 4
6 isolates of inducible Amp C cephalosporinase producing Enterobacteriaceae
. The majority of the resistance observed to imipenem and cefepime among te
sted Indoneisian strains was attributable to the nonfermenztative Gram-nega
tive bacilli, P. aeruginosa and Acinetobacter spp. These results indicate t
he presence of beta-lactam resistance in Indonesia and the need for continu
ed antimicrobial surveillance in this nation and region of the world, prefe
rably using accurate quantitative methods. (C) 1999 Elsevier Science Inc.