Prevalence of extended spectrum beta-lactamase in Klebsiella pneumoniae

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Published: 2008-09-26
DOI: https://doi.org/10.18051/UnivMed.2008.v27.98-105
Keywords:
Extended spectrum a-lactamase, Klebsiella, antibiotics

Main Article Content

Elly Herwana
Department of Pharmacology, Medical Faculty, Trisakti University
Yenny Yenny
Department of Pharmacology, Medical Faculty, Trisakti University
Laurentia Pudjiadi
Department of Pharmacology, Medical Faculty, Trisakti University
Juius E Surjawidjaja
Department of Microbiology Medical Faculty, Trisakti University
Murad Lesmana
Department of Microbiology Medical Faculty, Trisakti University

Abstract

Increased irrational use of antibiotics promotes bacterial resistance to these drugs. Among the resistance mechanisms developed by bacteria is the production of â-lactamase which can destroy the â-lactam ring and cause resistance to the other â-lactam antibiotics, such as amoxycillin. Extended spectrum â-lactamase (ESBL), an enzyme found in bacterial plasmids, is capable of hydrolyzing third-generation cephalosporins, namely cefotaxime, ceftazidime, ceftriaxone, and the monobactams. ESBL is predominantly found in Klebsiellas spp., Escherichia coli and other bacteria of the Enterobacteriaceae family. This study was conducted to determine the prevalence of Klebsiella resistant to cephalosporins and the prevalence of those producing ESBL. A total of 65 clinical isolates of Klebsiella were tested by the disk diffusion method according to Kirby-Bauer to determine their antibiotic susceptiblity and by the double-disk synergy method to detect the presence of ESBL. The results show that 18.5% of Klebsiella isolates tested were resistant to ceftazidime and cefixime, 13.9% to ceftriaxone, and 23.1% to aztreonam. Testing for ESBL revealed that the prevalence of ESBL producers in clinical Klebsiella isolates ranged from 10.8% to 12.3%. The presence of ESBL, plus the potential for plasmid-mediated quinolone and carbapenem resistance, undoubtedly will create significant therapeutic problems in the future.

Article Details

Issue

Vol. 27 No. 3 (2008)

Section

Review Article

The journal allows the authors to hold the copyright without restrictions and allow the authors to retain publishing rights without restrictions.

How to Cite

Prevalence of extended spectrum beta-lactamase in Klebsiella pneumoniae. (2008). Universa Medicina, 27(3), 98-105. https://doi.org/10.18051/UnivMed.2008.v27.98-105

References

Bradford PA. Extended broad-spectrum ß-lactamases in the 21st century: characterization, epidemiology, and detection of this important resistance threat. Clin Microbiol Rev 2001; 49: 33-51.

Hoge CW, Gambel JM, Srijan A, Pitarangsi C, Echeverira P. Trends in antibiotic resistance among diarrheal pathogens isolated in Thailand over 15 years. Clin Infect Dis 1998; 26: 341-5.

Vercauteren E, Deschemaeker P, Ieven M, Sanders CC, Goossens H. Comparison of screening methods for detection of extended spectrum ß-lactamases and their prevalence among blood isolates of Escherichia coli and Klebsiella spp. in a Belgian Teaching Hospital. J Clin Microbiol 1997; 219: 1-7.

Shehabi AA, Mahafzah A, Baadran I, Qadar FA, Dajani N. High incidence of resistance of Klebsiella pneumoniae clinical isolates to extended spectrum ß-lactam drugs in intensive care units. Diagn Microbiol Infect Dis 2000; 36:53-6.

Quinteros M, Radice M, Gardella N, Rodriguez M, Costa N, Korbenfeld D, et al. Extended spectrum ß-lactamases in Enterobacteriaceae in Buenos Aires, Argentina, Public Hospitals. Antimicrob Agents Chemother 2003; 47: 2864-7.

Kang CI, Kim SH, Park WB, Lee KD, Kim HB, Kim EC, et al. Bloodstream infection due to extended-spectrum ß-Lactamase-producing Escherichia coli and Klebsiella pneumoniae: risk factors for mortality and treatment outcome, with special emphasis on antimicrobial therapy. Antimicrob Agents Chemother 2004; 48: 4574-81.

National Committee for Clinical Laboratory Standards. Performance standards for antimicrobial disk susceptibility testing sixth edition. M2-A6. Villanova (PA): NCCLS; 1997

National Committee for Clinical Laboratory Standards. Performance standards for antimicrobial disk susceptibility testing - tenth informational supplement. M100-S11 Wayne (PA): NCCLS: 2001.

Subha A, Ananthan S. Extended spectrum beta lactamase (ESBL) mediated resistance to third generation cephalosporins among Klebsiella pneumoniae in Chennai, Indian J Med Microbiol 2002; 20: 92-5.

Jacoby GA. Antimicrobial-resistant pathogens in the 1990s. Annu Rev Med 1996; 47: 169-79.

Sirot D. Extended-spectrum plasmid-mediated beta lactamases. Antimicrob Agents Chemother 1995; 36: 19-34.

Ministry of Health Malaysia, Academy of Medicine of Malaysia, Malaysian Society of Infectious Diseases and Chemotherapy. Consensus guidelines for the management of infections by ESBL-producing bacteria; 2001.

Severin JA, Mertaniasih NM, Kuntaman K, Lemmens N, Verbrugh HA, Goessens WHF. Evaluation of the Vitek 2R ESBL test in detecting ESBL-positive clinical Escherichia coli and Klebsiella pneumoniae isolates. In: Proceedings of the 16th European Congress of Clinical Microbiology and Infectious Diseases; 2006 Apr 1-4; Nice, France. Oxford: Blackwell Publishing; 2006. p. 451.

Spanu T, Luzzaro F, Perilli M, Amicosante G, Toniolo A, Fadda G, et al. Occurrence of extended-spectrum â-lactamases in members of the family Enterobacteriaceae in Italy: implications for resistance to â-lactams and other antimicrobial drugs. Antimicrob Agents Chemother 2002; 46: 196-202.

Saurina G, Quale JM, Manikal VM, Oydna E, Landman D. Antimicrobial resistance in Enterobacteriaceae in Brooklyn, NY: epidemiology and relation to antibiotic usage patterns. J Antimicrob Chemother 2000; 45:895-8.

De Champs C, Sirot D, Chanal C, Bonnet R, Sirot J, The French Study Group. A 1998 survey of extended-spectrum â-lactamases in Enterobacteriaceae in France. Antimicrob Agents Chemother 2000; 44: 3177-9.

Bisson G, Fishman NO, Patel JB, Edelstein PH, Lautenbach E. Extended-spectrum â-lactamase producing Escherichia coli and Klebsiella species: risk factor for colonization and impact of antimicrobial formulary interventions on colonization prevalence. Infect Control Hosp Epidemiol 2002; 23: 254-60.

Du B, Long Y, Liu H, Chen D, Liu D, Xu Y, et al. Extended-spectrum â-lactamase producing Escherichia coli and Klebsiella pneumoniae bloodstream infection: risk factors and clinical outcome. Intensive Care Med 2002; 28: 1718-23.

Tumbarello M, Spanu T, Sanguinetti M, Citton R, Montuori E, Leone F, et al. Bloodstream infection caused by extended-spectrum â-lactamase producing Klebsiella pneumoniae: risk factors, molecular epidemiology, and clinical outcome. Antimicrob Agents Chemother 2006; 50: 498-504.

Schwaber MJ, Navon-Venezia S, Kaye KS, Ben-Ami R, Schwartz D, Carmeli Y. Clinical and economic impact of bacteremia with extended spectrum â-lactamase producing enterobacteriaceae. Antimicrob Agents Chemother 2006; 50: 1257-62.

Rahal JJ, Urban C, Horn D, Freeman K, Segal-Maurer S. Maurer J, et al. Class restriction of cephalosporin use to control total cephalosporin resistance in nosocomial Klebsiella. JAMA 1998; 280: 1233-7.

Szabo D, Filetoth Z, Szentandrassy J, Nemedi M, Toth E, Jeney C, et al. Molecular epidemiology of a cluster of cases due to Klebsiella pneumoniae producing SHV-5 extended-spectrum beta-lactamase in the premature intensive care unit of a Hungarian hospital. J Clin Microbiol 1999; 37: 4167-9.

Patterson JE, Hardin TC, Kelly CA, Garcia RC, Jorgensen JH. Association of antibiotic utilization measures and control of multiple-drug resistance in Klebsiella pneumoniae. Infect Control Hosp Epidemiol 2000; 21: 455-8.

Paterson DL, Bonomo RA. Extended-spectrum-lactamases: a clinical update. Clin Microbiol Rev 2005; 18: 657-86.

Baraniak A, Sadowy E, Hryniewicz W, Gniadkowski M. Two different extended spectrum beta-lactamases (ESBLs) in one of the first ESBL-producing Salmonella isolates in Poland. J Clin Microbiol 2002; 40: 1095-7.

Shen D, Winokur P, Jones RN. Characterization of extended spectrum beta-lactamase-producing Klebsiella pneumoniae from Beijing, China. Int J Antimicrob Agents 2001; 18: 185-8.