Determination of the Frequency of Extended Spectrum Beta Lactamase Producing Klebsiella Pneumoniae Causing Nosocomial Infections in Suez Canal University Hospital
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- Category: Vol. 78, March 2010
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Determination of the Frequency of Extended Spectrum Beta Lactamase Producing Klebsiella Pneumoniae Causing Nosocomial Infections in Suez Canal University Hospital, HASSAN N. MOHAMAD, GEHAN S. EL-HADIDY, ABEER G.A. RABIE and MARWA M.F.M. ANWAR
Abstract
Background: Nosocomial Klebsiella infections are caused mainly by Klebsiella pneumoniae (K. pneumoniae), the med-ically most important species of the genus, which accounts for a significant proportion of hospital-acquired urinary tract infections, pneumonia, septicemias and soft tissue infections. The Extended Spectrum Beta Lactamase (ESBL)-producing Klebsiella have increased rapidly and became a major problem in the area of infectious diseases.
Objectives: This study was carried out to determine the frequency of ESBL producing K. pneumoniae among all nosocomial infections in Suez Canal University Hospital in Ismailia.
Methods: The study involved 109 hospitalized patients with evidence of nosocomial infections. Specimens included urine, sputum, blood and pus. The collected specimens were processed for the isolation and identification of Klebsiella species and detection of ESBLs production (using the National Committee for Clinical Laboratory Standards ''NCCLS'' screen-ing test for ESBL-Production and the Minimal Inhibitory Concentration method ''MIC'' for screening and NCCLS phenotypic confirmatory test and double-disc synergy "DDS" test for confirmation).
Results: Klebsiella represented 17.4% of all nosocomial infections in this study with K. pneumoniae being the most common isolated strains (89.5%). 73.7% of the isolated Klebsiella strains were found to be ESBL producers and ESBL-producing K. pneumoniae represented 11% of all nosocomial infections. Nosocomial ESBL-producing K. pneu-moniae were most frequently isolated from the urology de-partment (50% of the total ESBL-producing K. pneumoniae isolates). Urine samples had the highest percentage of isolates representing 58.3% followed by sputum samples representing 25%. The resistance rates against cefotaxime, ceftazidime, ceftriaxone and aztreonam were found to be significantly higher in ESBL producing strains of Klebsiella than non-ESBL producing strains.
Conclusion: ESBL-producing Klebsiella represent a prev-alent problem in Suez Canal University Hospitals. The unjus-tified use of third-generation cephalosporin can be considered as a major cause of such problem. Multidrug resistance, difficulty in detection and treatment and increased mortality represent the major problems encountered with ESBLs. There-fore, restricting the use of third-generation cephalosporins, along with implementation of infection control measures, are the most effective means of controlling and decreasing the spread of ESBL isolates.