Literature DB >> 17635342

Influence of third-generation cephalosporin utilization on the occurrence of ESBL-positive Klebsiella pneumoniae strains.

K Urbánek1, M Kolár, Y Lovecková, J Strojil, L Santavá.   

Abstract

BACKGROUND: Klebsiella pneumoniae belongs to important nosocomial pathogens causing mainly hospital-acquired infections. Beta-lactam antibiotics are frequently used in the treatment of infections caused by K. pneumoniae, but by their selection pressure the bacteria become resistant. Excessive use of third-generation cephalosporins is a risk factor for the occurrence and spread of ESBL-producing bacterial strains. The goal of this study was to describe the utilization of third-generation cephalosporins and to analyse their selection pressure on K. pneumoniae in the University Hospital in Olomouc.
METHODS: Data on the utilization of antibiotics in the hospital were obtained for the period 1997-2005 from the computerized database and expressed in defined daily doses per 100 bed-days (DBD). The data were processed according to the ATC/DDD system. Klebsiella pneumoniae strains were isolated from clinical material obtained from hospitalized patients.
RESULTS: Consumption of third-generation cephalosporins, which was 1.79 DBD in 1997, decreased to 0.93 in 1999, remained stable until 2002, and then increased to 2.40 DBD in 2005. During the 9-year period analysed, a total of 9564 strains of K. pneumoniae were isolated. The ESBL-positive K. pneumoniae strains frequency increased from 8% to 18%.
CONCLUSIONS: Increasing utilization of third-generation cephalosporins was associated with a statistically and clinically significant increased incidence of ESBL-positive K. pneumoniae strains.

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Year:  2007        PMID: 17635342     DOI: 10.1111/j.1365-2710.2007.00836.x

Source DB:  PubMed          Journal:  J Clin Pharm Ther        ISSN: 0269-4727            Impact factor:   2.512


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