PMID- 18028795
OWN - NLM
STAT- MEDLINE
DCOM- 20080711
LR  - 20181201
IS  - 0578-1426 (Print)
IS  - 0578-1426 (Linking)
VI  - 46
IP  - 9
DP  - 2007 Sep
TI  - [Replacement of third-generation cephalosporins by piperacillin-tazobactam 
      decreases colonization of extended-spectrum beta-lactamases-producing intestinal 
      Escherichia coli].
PG  - 714-7
AB  - OBJECTIVE: To investigate the role of replacement of third-generation 
      cephalosporins by piperacillin-tazobactam (pip-tazo) in influencing the 
      colonization of extended-spectrum beta-lactamases (ESBLs)-producing Escherichia 
      coli (E. coli) in intestinal tract. METHODS: The study was divided into two 
      phases lasting altogether 9 months, namely the pre-replacement phase (phase I, 3 
      months) and replacement phase (phase II, 6 months). In the latter phase, 
      third-generation cephalosporins was restricted and replaced by pip-tazo. In phase 
      I and phase IIb (the last 3 months of phase II), clinical data and rectal swab 
      were taken for E. coli isolation as follow: within 24 hrs after admission 
      (baseline screening), every week and 48 hrs before discharge. ESBLs production 
      was detected with double disc test. Acquisition rate of ESBLs-producing E. coli 
      were calculated both in ES1 group (patients' rectal swab collected and tests at 
      least 2 times) and ES2 group (ES1 but with negative ESBLs either at the time of 
      screening on admission or at anytime during the hospital stay). Continuous 
      variable was compared using unpaired t-test and categorical variables was 
      compared using Pearson Chi square test. Fisher's exact test was used in the two 
      phases. RESULTS: In phase IIb, as compared with in phase I, the total consumption 
      of antibiotics other than pip-tazo was reduced by 38.40%, the third-generation 
      cephalosporins consumption was reduced by 70.11%, but pip-tazo consumption was 
      raised by 895.35%. Meanwhile, the acquisition rate of ESBLs-producing E. coli in 
      rectal swab was significantly decreased in phase IIb as compared with phase I 
      (11.4% vs 24.0%) in ES1 group and the same is true in ES2 group (11.8% vs 27.9%). 
      CONCLUSION: Replacement of third-generation cephalosporin with pip-tazo can 
      reduce colonization of ESBLs--producing E. coli in intestinal tract.
FAU - Zhao, Zong-Min
AU  - Zhao ZM
AD  - Division of Infectious Disease, the First Affiliated Hospital, China Medical 
      University, Shenyang 110001, China.
FAU - Chu, Yun-Zhuo
AU  - Chu YZ
FAU - Wan, Jian-Hua
AU  - Wan JH
FAU - Bai, Yu-Lan
AU  - Bai YL
FAU - Zhang, Jing-Ping
AU  - Zhang JP
FAU - Li, Jing-Bo
AU  - Li JB
FAU - Wang, Xin
AU  - Wang X
FAU - Wang, Qian
AU  - Wang Q
FAU - Li, Li-Yun
AU  - Li LY
FAU - Chen, Bai-Yi
AU  - Chen BY
LA  - chi
PT  - Journal Article
PL  - China
TA  - Zhonghua Nei Ke Za Zhi
JT  - Zhonghua nei ke za zhi
JID - 16210490R
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Cephalosporins)
RN  - 157044-21-8 (Piperacillin, Tazobactam Drug Combination)
RN  - 87-53-6 (Penicillanic Acid)
RN  - EC 3.5.2.6 (beta-Lactamases)
RN  - X00B0D5O0E (Piperacillin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anti-Bacterial Agents/*pharmacology/therapeutic use
MH  - Cephalosporins/pharmacology/therapeutic use
MH  - Escherichia coli/*drug effects/enzymology
MH  - Escherichia coli Infections/metabolism/prevention & control
MH  - Female
MH  - Humans
MH  - Intestines/drug effects/microbiology
MH  - Male
MH  - Middle Aged
MH  - Penicillanic Acid/analogs & derivatives/pharmacology/therapeutic use
MH  - Piperacillin/pharmacology/therapeutic use
MH  - Piperacillin, Tazobactam Drug Combination
MH  - Prospective Studies
MH  - beta-Lactam Resistance
MH  - beta-Lactamases/*metabolism
EDAT- 2007/11/22 09:00
MHDA- 2008/07/12 09:00
CRDT- 2007/11/22 09:00
PHST- 2007/11/22 09:00 [pubmed]
PHST- 2008/07/12 09:00 [medline]
PHST- 2007/11/22 09:00 [entrez]
PST - ppublish
SO  - Zhonghua Nei Ke Za Zhi. 2007 Sep;46(9):714-7.