High prevalence of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a tertiary care hospital in Tehran, Iran
Background: Extended-spectrum beta (β)-lactamase (ESBL)-producing enterobacteria are major emerging pathogens in nosocomial infections. Methodology: The combination disk synergy test was used to evaluate 202 consecutive non-repeated Klebsiella pneumoniae (K. pneumonia) strains for ESBL production...
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The Journal of Infection in Developing Countries
2009-12-01
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| Series: | Journal of Infection in Developing Countries |
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| Online Access: | https://jidc.org/index.php/journal/article/view/488 |
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| author | Hadi Mehrgan Mohammad Rahbar Zohreh Arab-Halvaii |
| author_facet | Hadi Mehrgan Mohammad Rahbar Zohreh Arab-Halvaii |
| author_sort | Hadi Mehrgan |
| collection | DOAJ |
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Background: Extended-spectrum beta (β)-lactamase (ESBL)-producing enterobacteria are major emerging pathogens in nosocomial infections.
Methodology: The combination disk synergy test was used to evaluate 202 consecutive non-repeated Klebsiella pneumoniae (K. pneumonia) strains for ESBL production. The strains were isolated from various clinical specimens of hospitalized patients over the period from July 2005 to March 2007. Their antibiotic susceptibility pattern was also determined by the disk diffusion method. Demographic and medical data of the patients were recorded using a questionnaire.
Results: One hundred and fifty-seven (77.7%) of the isolates were confirmed as ESBL-producers. By univariate analysis, young age, stay in intensive care unit (ICU)/medical wards, recent stay in ICU, and number of days of ICU stay were found to be risk factors for acquisition of resistant bacteria (χ2 and Mann-Whitney U tests, P < 0.05). However, binary logistic multivariate regression analysis confirmed that stay in ICU [Odds ratio (OR) 6.09, 95% confidence interval (CI) 2.36-15.72; P < 0.001] or medical wards [OR 3.72, 95% CI 1.42-9.75; P = 0.007] were significantly associated with ESBL production. Imipenem, ofloxacin, cefoxitin and norfloxacin (against urinary isolates) were found to be highly active against ESBL-producing isolates in vitro (100%, 75.2%, 69.4% and 66.7% susceptibility, respectively). In addition to most β-lactams, they showed co-resistance with other antibiotics such as ciprofloxacin, aminoglycosides, trimethoprim/sulfamethoxazole and tetracycline.
Conclusion: Our results showed a high prevalence of ESBL-producing K. pneumoniae in our hospital setting. As the available treatment options are limited, antibiotic control policies together with the implementation of infection control measures remain of high importance.
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| format | Article |
| id | doaj-art-c871adba68b944a48f966db07c2cf704 |
| institution | OA Journals |
| issn | 1972-2680 |
| language | English |
| publishDate | 2009-12-01 |
| publisher | The Journal of Infection in Developing Countries |
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| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-c871adba68b944a48f966db07c2cf7042025-08-20T02:27:12ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802009-12-0140310.3855/jidc.488High prevalence of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a tertiary care hospital in Tehran, IranHadi Mehrgan0Mohammad Rahbar1Zohreh Arab-Halvaii2Department of Pharmaceutics, School of Pharmacy and Pharmaceutical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran3Iranian Health Reference Laboratories, Ministry of Health, TehranDepartment of Pharmaceutics, School of Pharmacy Tehran Background: Extended-spectrum beta (β)-lactamase (ESBL)-producing enterobacteria are major emerging pathogens in nosocomial infections. Methodology: The combination disk synergy test was used to evaluate 202 consecutive non-repeated Klebsiella pneumoniae (K. pneumonia) strains for ESBL production. The strains were isolated from various clinical specimens of hospitalized patients over the period from July 2005 to March 2007. Their antibiotic susceptibility pattern was also determined by the disk diffusion method. Demographic and medical data of the patients were recorded using a questionnaire. Results: One hundred and fifty-seven (77.7%) of the isolates were confirmed as ESBL-producers. By univariate analysis, young age, stay in intensive care unit (ICU)/medical wards, recent stay in ICU, and number of days of ICU stay were found to be risk factors for acquisition of resistant bacteria (χ2 and Mann-Whitney U tests, P < 0.05). However, binary logistic multivariate regression analysis confirmed that stay in ICU [Odds ratio (OR) 6.09, 95% confidence interval (CI) 2.36-15.72; P < 0.001] or medical wards [OR 3.72, 95% CI 1.42-9.75; P = 0.007] were significantly associated with ESBL production. Imipenem, ofloxacin, cefoxitin and norfloxacin (against urinary isolates) were found to be highly active against ESBL-producing isolates in vitro (100%, 75.2%, 69.4% and 66.7% susceptibility, respectively). In addition to most β-lactams, they showed co-resistance with other antibiotics such as ciprofloxacin, aminoglycosides, trimethoprim/sulfamethoxazole and tetracycline. Conclusion: Our results showed a high prevalence of ESBL-producing K. pneumoniae in our hospital setting. As the available treatment options are limited, antibiotic control policies together with the implementation of infection control measures remain of high importance. https://jidc.org/index.php/journal/article/view/488Klebsiella pneumoniaeESBLbeta-lactamasesNosocomial infectionEnterobacteriaceae |
| spellingShingle | Hadi Mehrgan Mohammad Rahbar Zohreh Arab-Halvaii High prevalence of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a tertiary care hospital in Tehran, Iran Journal of Infection in Developing Countries Klebsiella pneumoniae ESBL beta-lactamases Nosocomial infection Enterobacteriaceae |
| title | High prevalence of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a tertiary care hospital in Tehran, Iran |
| title_full | High prevalence of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a tertiary care hospital in Tehran, Iran |
| title_fullStr | High prevalence of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a tertiary care hospital in Tehran, Iran |
| title_full_unstemmed | High prevalence of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a tertiary care hospital in Tehran, Iran |
| title_short | High prevalence of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a tertiary care hospital in Tehran, Iran |
| title_sort | high prevalence of extended spectrum beta lactamase producing klebsiella pneumoniae in a tertiary care hospital in tehran iran |
| topic | Klebsiella pneumoniae ESBL beta-lactamases Nosocomial infection Enterobacteriaceae |
| url | https://jidc.org/index.php/journal/article/view/488 |
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