Abstract
To guide selection of carbapenems or fourth-generation cephalosporins as therapy, 110 Klebsiella pneumoniae isolates with extended-spectrum β-lactamases from Taiwan were characterized by phenotypic (MICs), molecular, and chemical methods. MIC patterns of ceftazidime and cefepime clearly differentiate strains treatable by cefepime and those capable of efficiently hydrolyzing available cephalosporins (CTX-M series and SHV-types). Continued use of cefepime appears to be a treatment option in cases for which MIC results are available and interpreted by the criteria presented.
Highlights
I n recent years, extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBL-KP) strains of the TEM, SHV, and CTX-M types have been discovered worldwide
The Isoelectric focusing (IEF) results of 110 geographically representative isolates of ESBL-KP were categorized by cefepime MIC level (Table)
Szabo et al reported an outbreak of 14 ESBL-KP strains that had high-level resistance to cefepime (MIC90 >256 mg/L) [12]
Summary
I n recent years, extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBL-KP) strains of the TEM, SHV, and CTX-M types have been discovered worldwide. (6,7) for 211 isolates of endemic and epidemic ESBL-KP from Taiwan; 53% of isolates had a cefepime MIC of
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