High incidence of Klebsiella pneumoniae clinical isolates to extended-spectrum B-lactam drugs in intensive care units.
A prospective study conducted among Jordanian ICU patients in 1997 using Etest identified resistance rates among isolates of E. coli (25%-44%), Enterobacter spp. (54%-62%), and Klebsiella spp. (30%-80%) to extended-spectrum B-lactams (ESBLs): ceftazidime, cefotaxime, ceftriaxone, and aztreonam. All these isolates were susceptible to imipenem and showed low resistance rate to ciprofloxacin (5%-19%) and amikacin (13%-18%). Higher and significant resistance rates of Klebsiella isolates to ceftazidime (80%) and aztreonam (65%) were observed in 1997 compared with a previous study performed in 1994. The majority of Klebsiella pneumoniae (70%) express different ESBL phenotypes that were almost resistant to aztreonam and ceftazidime but susceptible or resistant to cefotaxime and/or ceftriaxone. This prospective study strongly suggests that ESBL production of Klebsiella pneumoniae isolates have been highly disseminated among ICU patients during 1997.
Shehabi
A A
AA
Department of Pathology-Microbiology, Faculty of Medicine, Jordan University Hospital, Amman. Toxico@ju.edu.jo
Mahafzah
A
A
Baadran
I
I
Qadar
F A
FA
Dajani
N
N
D001398:Aztreonam / Q000494:pharmacology; D002439:Cefotaxime / Q000494:pharmacology; D002442:Ceftazidime / Q000494:pharmacology; D002443:Ceftriaxone / Q000494:pharmacology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007597:Jordan / Q000453:epidemiology; D007710:Klebsiella Infections / Q000188:drug therapy / Q000453:epidemiology*; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000302:isolation & purification*; D007769:Lactams / Q000494:pharmacology* / Q000627:therapeutic use; D008826:Microbial Sensitivity Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018440:beta-Lactam Resistance
D007769:Lactams; D002443:Ceftriaxone; D002442:Ceftazidime; D001398:Aztreonam; D002439:Cefotaxime