Journal Article

A 12 year (1998–2009) antibiotic resistance surveillance of <i>Klebsiella pneumoniae</i> collected from intensive care and urology patients in 14 Dutch hospitals

C. F. M. van der Donk, P. S. Beisser, J. A. A. Hoogkamp-Korstanje, C. A. Bruggeman and E. E. Stobberingh

in Journal of Antimicrobial Chemotherapy

Published on behalf of British Society for Antimicrobial Chemotherapy

Volume 66, issue 4, pages 855-858
Published in print April 2011 | ISSN: 0305-7453
Published online January 2011 | e-ISSN: 1460-2091 | DOI: http://dx.doi.org/10.1093/jac/dkq538
A 12 year (1998–2009) antibiotic resistance surveillance of Klebsiella pneumoniae collected from intensive care and urology patients in 14 Dutch hospitals

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Objectives

We evaluated the changes in antibiotic resistance from 1998 to 2009 of Klebsiella pneumoniae isolated from the intensive care units (ICUs) and urology services of 14 Dutch hospitals and the consequences for empirical therapy.

Methods

Quantitative antibiotic susceptibility testing of K. pneumoniae was performed in a central laboratory using a microbroth dilution method. Breakpoints were as defined by the European Committee on Antimicrobial Susceptibility Testing (EUCAST). The prevalence of extended-spectrum β-lactamase (ESBL)- and carbapenemase-producing isolates was determined.

Results

A significant increase in resistance among ICU isolates was observed for ceftazidime (4.2%–10.8%), ciprofloxacin (5.8%–18.5%) and trimethoprim/sulfamethoxazole (11.9%–23.1%), and for cefuroxime (2.8%–7.9%) and trimethoprim/sulfamethoxazole (13.5%–27.8%) among urology isolates. Among ICU isolates the prevalence of ESBLs increased significantly from 2% to 8%. Carbapenemase production was not demonstrated. Among ICU isolates the prevalence of multidrug resistance increased and has been ≥12% since 2004. Among urology isolates multidrug resistance was highest in 2009 at 7.4%. Overall, resistance was significantly higher among ICU isolates.

Conclusions

We observed an increase in resistance among ICU and urology isolates and an increased prevalence of ESBLs among ICU isolates. Carbapenemase production was not demonstrated. A regular update of empirical treatment protocols based on actual surveillance data is justified.

Keywords: Enterobacteriaceae; β-lactam antibiotics; fluoroquinolones; ESBLs

Journal Article.  2067 words. 

Subjects: Medical Oncology ; Critical Care

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