The evaluation of antibiotic resistance status of Klebsiella pneumoniae

Abstract

Purpose: Klebsiella species can be found in the nasopharynx and intestine, rare pathogen but causes serious infections. Those kinds isolated from people most frequently from Klebsiella pneumoniae (K. pneumoniae) and Klebsiella oxytoca; like urinary tract, gallbladder, surgical site infection, bacteremia, pneumonia and abscesses in various organs infections bacteria identified as a factor. Urinary tract infections are the most common infections among community acquired and health care related infections. Thus treatment is usually given empirically, it is necessary and important to know the pathogens and the antibiotic susceptibility patterns of these pathogens in urinary tract infections for the success of treatment. Therefore in this study, antimicrobial susceptibility of 871 K. pneumoniae strains isolated from various clinical samples was investigated in our hospital. Material and Method: Between the April 2014-October 2015, sent to Sakarya University Training and Research Hospital medical microbiology laboratory isolated from various clinical specimens 871 K. pneumoniae isolates were included to study. Isolates, eosin methylene blue (EMB) agar and blood agar cultivation was carried out and samples were incubated at 37 °C for 18-24 hours. Vitek 2 (bioMérieux, France) automatised system was used for identification and antibiotic susceptibility tests, and susceptibility results were determined according to the guidelines of CLSI and/or EUCAST. Using the SPSS version 20.0 (SPSS, Inc., USA) program was performed descriptive statistical analysis of the isolates in our study . Results: K. pneumoniae strains were frequently isolated from urine (415, 48%), blood (91, 10%), wound (76, 9%), tracheal aspirate (52, 6%), sputum (19, %2) and (218, %25) other samples. The rates of ESBL production that was detected in all isolated-strain were 55% . The resistance rate was 37% in all isolates-strains for the only beta-lactam antibiotic, carbapenem group that can be used in the treatment of infections caused by ESBL producing strains. Resistance values of ESBL producing strains; for AN, AMC, CRO, CIP, CAZ, FEP, GM, IPM, MEM, SXT, TZP antibiotics respectively were found to be 8%, 34%, 24%, 51%, 28%, 1%, 8%, 5%, 7%, 6%, 3%. Conclusion: There is a high rate of ESBL-producing K. pneumoniae isolates and also to the high rate of resistance to antimicrobial agents of these strains., making ESBL detection tests in the clinical microbiology laboratory and we believe that each hospital should periodically evaluate its own data and concordantly assess its antibiotic use policies.