[Evaluation of susceptibility and response to therapy with piperacillin-tazobactam in patients with infections caused by Escherichia coli with extended-spectrum β-lactamase (ESBL) CTX-M]

Rev Chilena Infectol. 2018 Aug;35(4):343-350. doi: 10.4067/s0716-10182018000400343.
[Article in Spanish]

Abstract

Background: Carbapenems are the preferred β-lactamics for treatment for infections caused by enterobacteria producing extended-spectrum β-lactamases (ESBL); however, clinical studies show effectiveness of piperacillin/tazobactam in certain infections by Escherichia coli ESBL producers.

Aim: To determine the clinical and micro-biological cure with piperacillin/tazobactam in patients with infections caused by E. coli ESBL producers, CTXM type.

Methods: Retrospective descriptive study with adults hospitalized in a university hospital. We included urinary tract infections (UTI), intra-abdominal infections (IAI), soft tissue infections (STI) and/or bacteremia.

Results: We studied 40 patients, where 65% corresponded to UTI, 25% to IAI and 10% were STI. The overall clinical cure was achieved in 89.4%, with the best results in the ITU (100%), followed by STI (80%) and 70% in IAI. The 85% of the strains had minimum inhibitory concentrations (MIC) ≤8 μg/ml and 70% with MIC ≤4 μg/mL, however the rate of failure were high in intra-abdominal infections with high inocula or not controlled; CTX-M-15 was found in the 62.5%.

Conclusions: Piperacillin/tazobactam was efficient to obtain clinical and microbiological cure in patients with infections caused by ESBL producers but susceptible E. coli, especially in UTI and STI and to a lesser extent in IAI.

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Escherichia coli / drug effects
  • Escherichia coli / isolation & purification
  • Escherichia coli Infections / drug therapy*
  • Escherichia coli Infections / enzymology
  • Escherichia coli Infections / microbiology
  • Escherichia coli Proteins / drug effects*
  • Female
  • Humans
  • Male
  • Piperacillin, Tazobactam Drug Combination / therapeutic use*
  • Retrospective Studies
  • Treatment Outcome
  • beta-Lactamases / drug effects*

Substances

  • Anti-Bacterial Agents
  • Escherichia coli Proteins
  • Piperacillin, Tazobactam Drug Combination
  • beta-Lactamases
  • beta-lactamase CTX-M, E coli