Journal Article

Clinical Characteristics and Molecular Epidemiology Associated with Imipenem-Resistant <i>Klebsiella pneumoniae</i>

Muhammad Ahmad, Carl Urban, Noriel Mariano, Patricia A. Bradford, Ellen Calcagni, Steven J. Projan, Karen Bush and James J. Rahal

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 29, issue 2, pages 352-355
Published in print July 1999 | ISSN: 1058-4838
Published online July 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/520214
Clinical Characteristics and Molecular Epidemiology Associated with Imipenem-Resistant Klebsiella pneumoniae

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Eight patients were infected or colonized with imipenem-resistant Klebsiella pneumoniae (IRKP) from December 1994 to November 1995. Initial Klebsiella isolates were susceptible to imipenem but resistant to all cephalosporins, aminoglycosides, and β-lactam inhibitor combinations. All patients had been in the surgical intensive care unit and had undergone abdominal surgery or tracheostomy during hospitalization. The average age of the patients was 71 years (range, 41–81 years). All patients were treated with imipenem for 5 to 36 days, and IRKP was recovered from each during or after therapy. Pulsed-field gel electrophoresis (PFGE) of the IRKP isolates revealed three distinct clonal patterns. Paired sequential isolates of imipenem-susceptible K. pneumoniae and IRKP from two patients had identical PFGE patterns, suggesting the development of clonal stepwise resistance to imipenem during therapy. Thus, imipenem resistance in Klebsiella may occur when this agent is used for treatment of infection due to ceftazidime- and aminoglycoside-resistant strains.

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

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