Epidemiology of ciprofloxacin resistance and its relationship to extended-spectrum beta-lactamase production in Klebsiella pneumoniae isolates causing bacteremia

Paterson D., Mulazimoglu L., Casellas J., Ko W., Goossens H., Von Gottberg A., ...Daha Fazla

CLINICAL INFECTIOUS DISEASES, cilt.30, sa.3, ss.473-478, 2000 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 30 Sayı: 3
  • Basım Tarihi: 2000
  • Doi Numarası: 10.1086/313719
  • Dergi Adı: CLINICAL INFECTIOUS DISEASES
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.473-478
  • Marmara Üniversitesi Adresli: Evet

Özet

A prospective study of Klebsiella pneumoniae bacteremia was performed in 12 hospitals in 7 countries, Of 452 episodes of bacteremia, 25 (5.5%) were caused by ii, pneumoniae that was resistant in vitro to ciprofloxacin. Extended-spectrum beta-lactamase (ESBL) production was detected in 15 (60%) of 25 ciprofloxacin-resistant isolates, compared with 68 (16%) of 427 ciprofloxacin-susceptible strains (P = .0001), Multivariate analysis revealed that risk factors for ciprofloxacin resistance in ii. pneumoniae included prior receipt of a quinolone (P = .0065) and an ESBL-producing strain (P = .012), In all, 18% of ESBL-producing isolates were also ciprofloxacin-resistant. Pulsed-held gel electrophoresis showed that 11 of the 15 ciprofloxacin-resistant ESBL-producing strains belonged to just 4 genotypes, suggesting that patient-to-patient transmission of such strains occurred. The close relationship between ESBL production and ciprofloxacin resistance is particularly worrisome because the first reported instance of plasmid-mediated ciprofloxacin resistance has been in an isolate of K. pneumoniae also possessing an ESBL.