Premium
Influence of third‐generation cephalosporin utilization on the occurrence of ESBL‐positive Klebsiella pneumoniae strains
Author(s) -
Urbánek K.,
Kolář M.,
Lovečková Y.,
Strojil J.,
Šantavá L.
Publication year - 2007
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/j.1365-2710.2007.00836.x
Subject(s) - klebsiella pneumoniae , cephalosporin , antibiotics , microbiology and biotechnology , medicine , incidence (geometry) , biology , escherichia coli , biochemistry , physics , optics , gene
Summary 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.