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Antibacterial susceptibility of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae and Escherichia coli.
Isr Med Assoc J. 2005 May; 7(5):298-301.IM

Abstract

BACKGROUND

The prevalence of extended-spectrum beta-lactamase-producing organisms and their antimicrobial resistance patterns may vary between geographic areas.

OBJECTIVES

To evaluate the prevalence and susceptibility of ESBL-producing organisms among Klebsiella pneumoniae and Escherichia coli isolated from adult and pediatric patients in two Israeli hospitals.

METHODS

ESBL production was tested according to recommendations of the Clinical and Laboratory Standards Institute, using ceftazidime (30 microg) and a combination of ceftazidime/clavulanate (30/ 10 microg) disks with a > or =5 mm difference indicating positivity. Antibiotic susceptibilities were determined by the disk diffusion method according to CLSI standards. Minimal inhibitory concentrations were determined by the E-test.

RESULTS

The prevalence of ESBL-producing organisms was significantly higher among K. pneumoniae than E. coli isolates - 32% (241/765) vs. 10% (57/547) respectively (P < 0.001), and more frequently isolated from adults than children (odds ratio 2.27 for K. pneumoniae and 12.94 for E. coli). Resistance rates for amoxicillin/ clavulanate, piperacillin-tazobactam, amikacin, and ciprofloxacin among the ESBL-producing K. pneumoniae and E. coli isolates were 95%, 82%, 49% and 77% for K. pneumoniae, and 77%, 35%, 25% and 100% for E coli. Two (0.8%) ESBL-producing and 4 (0.7%) ESBL-negative K. pneumoniae isolates showed intermediate susceptibility (MIC 6 microg/ml) to meropenem. All isolates were sensitive to ertapenem and colistin.

CONCLUSION

ESBL production among K. pneumoniae and E. coli is more prevalent in the adult population than the pediatric population and is associated with multidrug resistance.

Authors+Show Affiliations

Rabin Medical Center (Beilinson Campus), Petah Tiqva, Israel. bishara@netvision.net.ilNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15909461

Citation

Bishara, Jihad, et al. "Antibacterial Susceptibility of Extended-spectrum Beta-lactamase-producing Klebsiella Pneumoniae and Escherichia Coli." The Israel Medical Association Journal : IMAJ, vol. 7, no. 5, 2005, pp. 298-301.
Bishara J, Livne G, Ashkenazi S, et al. Antibacterial susceptibility of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae and Escherichia coli. Isr Med Assoc J. 2005;7(5):298-301.
Bishara, J., Livne, G., Ashkenazi, S., Levy, I., Pitlik, S., Ofir, O., Lev, B., & Samra, Z. (2005). Antibacterial susceptibility of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae and Escherichia coli. The Israel Medical Association Journal : IMAJ, 7(5), 298-301.
Bishara J, et al. Antibacterial Susceptibility of Extended-spectrum Beta-lactamase-producing Klebsiella Pneumoniae and Escherichia Coli. Isr Med Assoc J. 2005;7(5):298-301. PubMed PMID: 15909461.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antibacterial susceptibility of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae and Escherichia coli. AU - Bishara,Jihad, AU - Livne,Gilat, AU - Ashkenazi,Shai, AU - Levy,Itzhak, AU - Pitlik,Silvio, AU - Ofir,Orit, AU - Lev,Bruria, AU - Samra,Zmira, PY - 2005/5/25/pubmed PY - 2005/6/24/medline PY - 2005/5/25/entrez SP - 298 EP - 301 JF - The Israel Medical Association journal : IMAJ JO - Isr. Med. Assoc. J. VL - 7 IS - 5 N2 - BACKGROUND: The prevalence of extended-spectrum beta-lactamase-producing organisms and their antimicrobial resistance patterns may vary between geographic areas. OBJECTIVES: To evaluate the prevalence and susceptibility of ESBL-producing organisms among Klebsiella pneumoniae and Escherichia coli isolated from adult and pediatric patients in two Israeli hospitals. METHODS: ESBL production was tested according to recommendations of the Clinical and Laboratory Standards Institute, using ceftazidime (30 microg) and a combination of ceftazidime/clavulanate (30/ 10 microg) disks with a > or =5 mm difference indicating positivity. Antibiotic susceptibilities were determined by the disk diffusion method according to CLSI standards. Minimal inhibitory concentrations were determined by the E-test. RESULTS: The prevalence of ESBL-producing organisms was significantly higher among K. pneumoniae than E. coli isolates - 32% (241/765) vs. 10% (57/547) respectively (P < 0.001), and more frequently isolated from adults than children (odds ratio 2.27 for K. pneumoniae and 12.94 for E. coli). Resistance rates for amoxicillin/ clavulanate, piperacillin-tazobactam, amikacin, and ciprofloxacin among the ESBL-producing K. pneumoniae and E. coli isolates were 95%, 82%, 49% and 77% for K. pneumoniae, and 77%, 35%, 25% and 100% for E coli. Two (0.8%) ESBL-producing and 4 (0.7%) ESBL-negative K. pneumoniae isolates showed intermediate susceptibility (MIC 6 microg/ml) to meropenem. All isolates were sensitive to ertapenem and colistin. CONCLUSION: ESBL production among K. pneumoniae and E. coli is more prevalent in the adult population than the pediatric population and is associated with multidrug resistance. SN - 1565-1088 UR - https://www.unboundmedicine.com/medline/citation/15909461/Antibacterial_susceptibility_of_extended_spectrum_beta_lactamase_producing_Klebsiella_pneumoniae_and_Escherichia_coli_ L2 - http://www.ima.org.il/IMAJ/ViewArticle.aspx?year=2005&amp;month=05&amp;page=298 DB - PRIME DP - Unbound Medicine ER -