Journal Article

Bacteremia Due to <i>Klebsiella pneumoniae</i> Isolates Producing the TEM-52 Extended-Spectrum β-Lactamase: Treatment Outcome of Patients Receiving Imipenem or Ciprofloxacin

Andrea Endimiani, Francesco Luzzaro, Mariagrazia Perilli, Gianluigi Lombardi, Alessandra Colì, Antonio Tamborini, Gianfranco Amicosante and Antonio Toniolo

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 38, issue 2, pages 243-251
Published in print January 2004 | ISSN: 1058-4838
Published online January 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/380645
Bacteremia Due to Klebsiella pneumoniae Isolates Producing the TEM-52 Extended-Spectrum β-Lactamase: Treatment Outcome of Patients Receiving Imipenem or Ciprofloxacin

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The treatment outcome of 35 cases of bacteremia due to Klebsiella pneumoniae isolates producing TEM-52 extended-spectrum β-lactamase was studied. Twenty-eight cases, classified as “nonfatal disease” using the McCabe and Jackson classification, were investigated with regard to ciprofloxacin and imipenem response. Because ciprofloxacin was active in vitro against 21 of 28 isolates, only the treatment outcome of the ciprofloxacin-susceptible subgroup was evaluated. Eight of 10 cases occurred in patients who experienced a complete response to imipenem; 2 of 10 failed to respond. In contrast, only 2 of 7 cases had a partial response to ciprofloxacin, and, in 5 of 7 cases, the treatment failed. Statistical analysis revealed a significant difference in the treatment outcome of the 2 groups (P = .03). Because the isolates had minimum inhibitory concentrations of ciprofloxacin close to the susceptibility breakpoint, treatment failure could be ascribed to the inability of the drug to reach therapeutic concentrations at infected sites.

Journal Article.  4271 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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