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Resistance dynamics and multidrug resistance among Klebsiella spp. and Pseudomonas aeruginosa in severe sepsis

Abstract number: 1734_30

Slavcovici A., Flonta M., Lupse M., Hagau N., Almas A., Dicea A., Cismaru C.

Objective: The aim of this study is to assess the prevalence and trends of antibiotics resistance for Klebsiella spp. and P. aeruginosa strains isolated during 8 years period from medical and surgical hospitals.

Methods: There were isolated 288 Klebsiella spp. strains and 285 P. aeruginosa strains from patients with severe sepsis admitted on medical and surgical wards between 1999–2002 and 2003–2006 in Cluj-Napoca. Identification was performed with API 20E and API 20NE. Antibiotic susceptibility testing was performed by disk diffusion method and API ATB. Expression according to CLSI Guidelines. Strains with resistance at more than 3 antibiotic groups were considered multidrug resistant strains (MDR).

Results: On that two periods, resistance of Klebsiella spp. strains to ceftazidim and ciprofloxacin increased from 33% to 54% (p = 0.007) respectively from 26% to 30.3%. Amikacin, carbapenems and colistin resistance was constantly low. The frequency of ESBL strains significantly increased from 21% to 34.8% (p = 0.017). MDR strains were detected in 21.8% respectively in 23% of cases. 50.6% of these strains were isolated in nosocomial infections. There was significantly increasing resistance to ceftazidim and amikacin from 63% to 73% and from 25% to 37.5% (p = 0.03) in P. aeruginosa strains. Colistin and carbapenems resistance remain low. Comparing the two periods we detected significant increasing of MDR strains from 23.7% to 43.75% (p = 0.0003). 77.3% of these strains were isolated in nosocomial infections.

Conclusions:Klebsiella spp. and P. aeruginosa strains isolated from patients with severe sepsis demonstrate increasing trends of resistance to ceftazidim, ciprofloxacin and amikacin correlated with nosocomial infections. Carbapenems and colistin remains the only reliable antibiotics against MDR strains.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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