title: Multiple antibiotic resistance in Klebsiella spp. and other Enterobacteriaceae isolated in Singapore.
abstract: A common pattern of multiple antibiotic resistance has been noted in bacteria isolated from Singaporean patients. The resistance pattern includes: ampicillin, cefuroxime, ceftazidime and other third generation cephalosporins, aztreonam, gentamicin and other aminoglycosides. The bacterial species implicated are Klebsiellas and other members of the Enterobacteriaceae. Preliminary laboratory investigation with a disk-diffusion augmentation test suggests the presence of extended-spectrum beta-lactamases. A retrospective study of laboratory blood culture records shows a rising incidence of resistance in Klebsiella spp. since 1985. Antimicrobial susceptibility results suggest a high degree of co-transfer of aminoglycoside resistance. The high frequency of this type of multiple antibiotic resistance should result in greater caution in the selection of presumptive antibiotic therapy for septicaemia, in order to avoid treatment failure and further selection of resistant strains.
authors.affiliation: Department of Microbiology, National University of Singapore.
authors.forename: T J
authors.initials: TJ
authors.lastname: Inglis
authors.forename: G
authors.initials: G
authors.lastname: Kumarasinghe
authors.forename: C
authors.initials: C
authors.lastname: Chow
authors.forename: H Y
authors.initials: HY
authors.lastname: Liew
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002954:Citrobacter; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D004754:Enterobacter; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D015994:Incidence; D007710:Klebsiella Infections / Q000453:epidemiology / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D011159:Population Surveillance; D012189:Retrospective Studies; D012846:Singapore / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents