title: First national surveillance of susceptibility of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella spp. to antimicrobials in Israel.
abstract: In this 1st national surveillance study, the susceptibility pattern of 1011 consecutive isolates of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella spp. isolated from patients hospitalized in Israel hospitals, covering 62.3% of all general hospital beds in the country, was investigated. Proportion of susceptibilities (range among institutions, MIC(50)/MIC(90) in micrograms per milliliter) were to ertapenem 95.0% (88.8-100%, 0.19/0.75), imipenem 98.8% (88.8-100%, 0.25/0.38), meropenem 98.2% (90.0-100%, 0.06/0.19), piperacillin-tazobactam 59.1% (42.6-77.0%, 16/256), ciprofloxacin 17.2% (9.0-24.6%, 32/32), levofloxacin 17.8% (9.0-24.6%, 32/32), amikacin 74.5% (63.8-98.0%, 6/32), and gentamicin 19.3% (12.3-28.5%, 96/256). Coresistance, cross-resistance, and variability between institutions were high. Only carbapenems retain predicted activity against ESBL-producing E. coli and Klebsiella spp. across Israeli hospitals.
authors.affiliation: Clinical Microbiology Laboratory, Ha'Emek Medical Center, 18101, Afula, Israel. colodner_ra@clalit.org.il
authors.forename: Raul
authors.initials: R
authors.lastname: Colodner
authors.forename: Zmira
authors.initials: Z
authors.lastname: Samra
authors.forename: Nathan
authors.initials: N
authors.lastname: Keller
authors.forename: Hanna
authors.initials: H
authors.lastname: Sprecher
authors.forename: Colin
authors.initials: C
authors.lastname: Block
authors.forename: Nehama
authors.initials: N
authors.lastname: Peled
authors.forename: Tzilia
authors.initials: T
authors.lastname: Lazarovitch
authors.forename: Rita
authors.initials: R
authors.lastname: Bardenstein
authors.forename: Orna
authors.initials: O
authors.lastname: Schwartz-Harari
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Carmeli
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects* / Q000201:enzymology; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology; D006769:Hospitals, General; D006801:Humans; D007557:Israel / Q000453:epidemiology; D007709:Klebsiella / Q000187:drug effects* / Q000201:enzymology; D007710:Klebsiella Infections / Q000453:epidemiology / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D011159:Population Surveillance; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases