Differences in the evolution of imipenem susceptibility among Klebsiella pneumoniae and Escherichia coli isolates during a 6-year period in a tertiary care hospital

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• 作者：Joseph Papaparaskevas ; Angeliki Pantazatou ; Ioanna Stefanou ; Victoria Mela ; Nikolaos Galatidis ; Athina Avlamis
• 关键词：Imipenem ; Susceptibility ; Escherichia coli ; Klebsiella pneumoniae ; WHONET ; Surveillance
• 刊名：International Journal of Antimicrobial Agents
• 出版年：2007
• 出版时间：February 2007
• 年：2007
• 卷：29
• 期：2
• 页码：197-200
• 全文大小：582 K

文摘

The evolution of imipenem disk-diffusion susceptibility results of 2652 strains of Klebsiella pneumoniae and 7596 Escherichia coli isolated during the period 2000–2005 were analysed. Screening for production of metallo-β-lactamases was performed using the EDTA-synergy method. The percentage rate of K. pneumoniae isolates having a zone diameter ≤25 mm increased from 20 % in 2000 to 41 % in 2005, whereas the respective rate of isolates having a zone diameter ≥30 mm decreased from 48 to 23 % . These changes were more evident during 2000–2002, followed in 2003 by the isolation of the first imipenem-resistant strains. Regarding E. coli, a similar decrease was observed (the rates of isolates having a zone diameter ≤25 mm and ≥30 mm changed from 7 % and 68 % in 2000, to 32 % and 36 % in 2005, respectively) following the respective changes of K. pneumoniae. A total of 20 K. pneumoniae strains, but no E. coli, were confirmed as metallo-β-lactamase producers. In conclusion, a decrease of the imipenem susceptibility prior to the isolation of the first resistant strains in a tertiary care hospital was detected, as well as differences in this decrease between the two species. These findings indicate that monitoring of the evolution of imipenem susceptibility in real-time may help in unveiling forthcoming resistance and in implementing the appropriate diagnostic techniques.