Evolution of resistance to cefepime in patients with urinary tract infection

Abstract

Introduction: Urinary tract infections (UTIs) are among the most common infectious diseases occurring in either the community or healthcare setting.1 Uncomplicated UTIs typically occur in the healthy adult non-pregnant woman, while complicated UTIs (cUTIs) may occur in all sexes and age groups and are frequently Associated with either structural or functional urinary tract abnormalities. Examples include foreign bodies such as calculi indwelling catheters or other drainage devices, obstruction, immunosuppression, renal failure, renal transplantation and pregnancy

Aim: The purpose of our study is to highlight the alarming evolution of the resistance at Cefepime(the only cephalosporine of fourth generation) in patients with urinary tract infection. Material and Methods: Records from 1041 patients where retrospectively reviewed. Antibiotic susceptibility of the isolated pathogens was tested for commonly-used antibiotics(including Cefepime) by Kirby-Bauer technique according to NCCLS guidelines. All statistical analyses were performed SPSS software. Statistical significance was considered for a p value < 0.05(for Pearson Chi-Square test), and all p values were 2-sided. Results: In 2012 Cefepime resistance was 31,85%, in 2013: 32,46% and in 2014 36,17%. Cefepime has good efficiency on urinary tract infection caused by E.coli comparing with the other cephalosporines(p<0.0001) but for Klebsiella pneumoniae Cefotaxime has the best results.(p<0.0001). Conclusions: Cefepim resistance increased almost 5 percent these years. And this is a very big problem because is the only fourth generation cephalosporin that we have. In literature empirical treatment and self-medication is incriminated but we need further studies to provide accurate information.