Changing trends of carbapenem resistance of escherichia coli and klebsiella pneumoniae strains isolated from intensive care units, inpatient services and outpatient's clinics: a five years retrospective analysis

Abstract

Background: Carbapenem resistance (CR) was rarely reported in Klebsiella pneumoniae and Escherichia coli strains until ten years ago. In recent years, increasing carbapenem resistance in gram negative bacteria is a substantial concern. Objectives: In this study; we aimed to evaluate the changing frequency of CR in K.pneumoniae and E.coli strains that were isolated from the patients from intensive care units, inpatient services and outpatientsÂ’ clinics in the last five years. Methods: Data of antimicrobial susceptibility belonging to clinical isolates of K.pneumoniae and E.coli strains determined between 2013 and 2017 were retrospectively collected from Laboratory Information System. Results were statistically analyzed. Results: A total 4002 K.pneumoniae and 13462 E.coli strains were included. The CR of K.pneumoniae strains were found as 11.6%; while of E.coliÂ’s were found as 0.6%. The highest CR frequency was detected among intensive care unitsÂ’ isolates of K. pneumoniae as 20.1%. We determined that CR significantly increased in intensive care unit isolates of E.coli and K.pneumoniae about 5-10 folds throughout the study period; however, there was no remarkable change in the CR of E.coli strains from the outpatientsÂ’ clinics. Conclusion: We determined that the resistances of K.pneumoniae and E.coli strains to carbapenems were progressively increasing by years, especially in intensive care units and inpatient services. Therefore, appropriate antimicrobial use policies sought to be considered against to this growing problem.