Karamat Ahmed Karamat, Tariq Mahmood Ahmad, Shahid Ahmad Abbasi, Shahid Rafi.
In vitro efficacy of imipenem and piperacillin / tazobactam against multidrug resistant nosocomial gram-negative bacteria.
Pak J Pathol Jan ;10(4):4-8.

Nosocomial infections are an important cause of morbidity and mortality in the hospitalized patients and Gram negative bacilli are the most commonly encountered organisms in these infections. Exposure to a wide range of antibiotics has led to the emergence of multidrug resistant (MDR) strains and there is always a need for anti-microbial agents for their effective eradication. Imipenem and piperacillin / tazobactam are the two commonly used antibiotics in such clinical settings. This study was formulated to find out the susceptibility of the MDR Gram negative bacilli to these two antimicrobials. Out of a consecutive 100 isolates tested Escherichia coli [25], Klebsiella pneumoniae [25], Pseudomonas aeruginosa [22] followed by Enterobacter spp. [11] were the organisms isolated. Minimum inhibitory concentration (MIC) of imipenem and piperacillin / tazobactam was determined using the PDM Epsilometer test (E.test). Hundred percent isolates of Escherichia coli, Klebsiella pneumoniae and Enterobacter spp. and 91% isolates of Pseudomonas aeruginosa were susceptible to imipenem. Thirty six percent isolates of Pseudomonas aeruginosa, 32% Escherichia coli, 24% Klebsiella pneumoniae and 27.3% Enterobacter spp. were susceptible to piperacillin/ tazobactam. Most of the nosocomial isolates in our study have shown in vitro resistance against piperacillin / tazobactam A larger proportion was sensitive to imipenem, which establishes the fact that for the empirical therapy of life threatening nosocomial infections imipenem may be the preferred antibiotic in our set up.

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