Abstract
Abstract Background Infections with ESBL Klebsiella pneumoniae are increasing, particularly among patients in ICUs. This pathogen is usually multidrug-resistant and there are limited treatment options available. Active surveillance for ESBL-producing pathogens in high-risk populations should be performed using appropriate antimicrobial techniques. The carbapenems, that is, imipenem and meropenem, are safe and effective antibiotics for the treatment of severe ESBL-producing K. pneumoniae infection in preterm infants. Purpose To study the antibiotic sensitivity, detection of ESBL production and detection of carbapenemase of Klebsiella spp. in hospital-acquired infection. Methods Clinical specimens were collected in aseptic conditions and were cultured and suspected Gram-negative organisms were identified. Antimicrobial susceptibility was performed by modified Kirby–Bauer sensitivity testing methods. Suspected ESBL-producing isolates were tested further for ESBL production and confirmed. Screening and confirmatory tests were also performed for carbapenemase production. Result During the study, 170 patients with K. pneumoniae isolates were identified. ESBL-producing K. pneumoniae was detected in 30 of 170 patients (17%), AmpC β-lactamase producer in 109 of 170 patients (64%) and carbapenemase producer in 53 of 170 patients (31%). The most frequent sources of infection were blood (18%), pus and wound swab (18%), respiratory (32%) and urinary (29%). Conclusion The type of ESBL enzyme produced and the site and severity of infection are important considerations in determining antimicrobial therapy. Therefore, active surveillance for ESBL-producing organisms is critical to describe fully the local epidemiology of a given institution and/or referring centres; currently, the carbapenems, that is, imipenem and meropenem, are the only class of antimicrobials that have consistently been effective against ESBL-producing K. pneumoniae .
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