Medicine and Health Sciences Commons^™

Bloodstream Infection Due To Piperacillin/Tazobactam Non-Susceptible, Cephalosporin Susceptible Escherichia Coli: A Missed Opportunity For De-Escalation Of Therapy, Leah Carlisle, Julie Ann Justo, Majdi N. Al-Hasan

Faculty Publications

An increasing number of reports describing Escherichia coli isolates with piperacillin/tazobactam resistance, despite retained cephalosporin susceptibility, suggest further emergence of this phenotypic resistance pattern. In this report, a patient with metastatic breast cancer presented to medical care after two days of chills, nausea, vomiting, reduced oral intake, and generalized weakness. Blood and urine cultures grew E. coli as identified by rapid diagnostics multiplex PCR and MALDI-TOF, respectively. The patient continued to manifest signs of sepsis with hypotension and tachypnea during the first three days of hospitalization despite empirical antimicrobial therapy with intravenous piperacillin/tazobactam. After in vitro antimicrobial susceptibility testing demonstrated …