ArticleAntimicrobial agents and chemotherapy2008
Acquisition of rectal colonization by vancomycin-resistant Enterococcus among intensive care unit patients treated with piperacillin-tazobactam versus those receiving cefepime-containing antibiotic regimens.
Article in Antimicrobial agents and chemotherapy, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 37 citations in OpenAlex.
- Culture-enriched metagenomic sequencing reveals within-patient diversity and transmission of vancomycin-resistantMicrobial genomics · 2026Article
- Culture-enriched metagenomic sequencing reveals within-patient diversity and transmission of vancomycin-resistantmedRxiv : the preprint server for health sciences · 2026Article
- Bacteriocin production facilitates nosocomial emergence of vancomycin-resistant Enterococcus faecium.Nature microbiology · 2025Article
- Bacteriocin production facilitates nosocomial emergence of vancomycin-resistantmedRxiv : the preprint server for health sciences · 2024Article
- A targeted likelihood estimation comparing cefepime and piperacillin/tazobactam in critically ill patients with community-acquired pneumonia (CAP).Scientific reports · 2024Article
- Analysis of Vancomycin-Resistant Enterococci in Hemato-Oncological Patients.Antibiotics (Basel, Switzerland) · 2020Article
- Novel Strategies for the Management of Vancomycin-Resistant Enterococcal Infections.Current infectious disease reports · 2019Review
- Vancomycin-ResistantOpen forum infectious diseases · 2019Article
- Impact of antimicrobial therapy on the gut microbiome.The Journal of antimicrobial chemotherapy · 2019Review
- Duration of exposure to multiple antibiotics is associated with increased risk of VRE bacteraemia: a nested case-control study.The Journal of antimicrobial chemotherapy · 2018Article
- Patient-level analysis of incident vancomycin-resistant enterococci colonization and antibiotic days of therapy.Epidemiology and infection · 2016Article
- Driving forces of vancomycin-resistant E. faecium and E. faecalis blood-stream infections in children.Antimicrobial resistance and infection control · 2014Article
- Association between vancomycin-resistant Enterococci bacteremia and ceftriaxone usage.Infection control and hospital epidemiology · 2012Article
- Cefepime: a reappraisal in an era of increasing antimicrobial resistance.Expert review of anti-infective therapy · 2008Review
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In contrast to expanded-spectrum cephalosporins, beta-lactam-beta-lactamase inhibitor combinations such as piperacillin-tazobactam have rarely been associated with vancomycin-resistant Enterococcus (VRE) colonization and infection. In mice, piperacillin-tazobactam has sufficient antienterococcal activity to inhibit the establishment of colonization during treatment, but this effect has not been confirmed in human patients. We prospectively evaluated the acquisition of rectal colonization by VRE among intensive care unit patients receiving antibiotic regimens containing piperacillin-tazobactam versus those receiving cefepime, an expanded-spectrum cephalosporin with minimal antienterococcal activity. Rectal swabs were obtained weekly and were cultured for VRE. For 146 patients with a negative rectal swab for VRE prior to therapy, there was no significant difference in the frequency of VRE acquisition between patients receiving piperacillin-tazobactam- and cefepime-containing regimens (19/72 [26.4%] and 23/74 [31.1%], respectively; P = 0.28). Of the 19 patients who acquired VRE in association with piperacillin-tazobactam, 10 (53%) developed the new detection of VRE during therapy. Patients initiated on treatment with cefepime-containing regimens were significantly more likely than those initiated on treatment with piperacillin-tazobactam-containing regimens to have received antibiotic therapy in the prior 30 days (55/74 [74.3%] and 22/72 [30.6%], respectively; P < 0.001). These findings suggest that piperacillin-tazobactam- and cefepime-containing antibiotic regimens may be associated with the frequent acquisition of VRE in real-world intensive care unit settings. Although piperacillin-tazobactam inhibits the establishment of VRE colonization in mice when exposure occurs during treatment, our data suggest that this agent may not prevent the acquisition of VRE in patients.
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