title: Resistance status and evolution trends of Klebsiella pneumoniae isolates in a university hospital in Greece: ineffectiveness of carbapenems and increasing resistance to colistin.
abstract: BACKGROUND
  Due to its increased non-susceptibility rates, Klebsiella pneumoniae has emerged as one of the most problematic pathogens.
  
  
  METHODS
  The level of resistance to 25 antimicrobials of K. pneumoniae isolates from a teaching hospital in Greece and the evolution trends during 2 decades were examined.
  
  
  RESULTS
  A statistically significant increase in non-susceptibility rates was found for almost all antimicrobials examined. During 2008, the isolates presented non-susceptibility rates to aminoglycosides >50% and to quinolones >60%. Nowadays, 1 out of 10 isolates is non-susceptible to colistin. Moreover, the isolates non-susceptible to imipenem were almost doubled between 2007 (29%) and 2008 (50%). Among the imipenem-resistant isolates, 1 out of 4 was also resistant to colistin.
  
  
  CONCLUSIONS
  The effectiveness of carbapenems has been compromised and the increase in resistance to colistin is rapid and steep.
authors.affiliation: Department of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, University Hospital of Heraklion, Heraklion, Greece. ineonakis@gmail.com
authors.forename: I K
authors.initials: IK
authors.lastname: Neonakis
authors.forename: G
authors.initials: G
authors.lastname: Samonis
authors.forename: H
authors.initials: H
authors.lastname: Messaritakis
authors.forename: S
authors.initials: S
authors.lastname: Baritaki
authors.forename: A
authors.initials: A
authors.lastname: Georgiladakis
authors.forename: S
authors.initials: S
authors.lastname: Maraki
authors.forename: D A
authors.initials: DA
authors.lastname: Spandidos
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D015780:Carbapenems / Q000494:pharmacology* / Q000627:therapeutic use; D003091:Colistin / Q000494:pharmacology* / Q000627:therapeutic use; D024901:Drug Resistance, Multiple, Bacterial / Q000502:physiology; D006115:Greece / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D003091:Colistin