Epidemiology of Enterobacteriaceae with reduced susceptibility to third-generation cephalosporins isolated from stool screening at entry to a tertiary care hospital

J. Chan, D. Lye, Y.S. Leo, T.H. Koh, W.Y. Tang, A. Singh, P. Krishnan
2008 International Journal of Infectious Diseases  
e358 13th International Congress on Infectious Diseases Abstracts, Poster Presentations acinetobacters to imipenem decreased from 96% to 35% in a decade, although amikacin retained its effectiveness, susceptibility ranging from 83% to 65%. For P. aeroginosa, susceptibility to imipenem was 88% in Phase I, 63% in Phase II, 42% in Phase III and 83% in Phase IV. The corresponding rates of susceptibility to ceftazidine were 81%, 50%, 67% and 87%; and that to amikacin were 98%, 97%, 70% and 91%.
more » ... ptibility of inducible enterobacteriaceae to all ranges of antibiotics was retained, all isolates were sensitive to imipenem and ciprofloxacin, gentamicin and amikacin in the last phase. Resistance to ceftazidine in Klebsiella and E. coli was frequent in the first two phases and was predominantly due to EBSL production. The incidence of EBSL producing Klebsiella spp and E. coli was variable over the 4 phases, showing a decrease in the last two phases for EBSL producing Klebsiella and an absence in the third phase for the EBSL producing E. coli. Conclusion: The above findings will have a significant impact on the empiric treatment of sepsis in critically ill patients. Emerging problems of multiresistance in P. aeroginosa and Acinetobacters and the growing threat of EBSL producing organisms in Malaysian hospitals is of concern to all and calls for a concerted effort towards the control of emergence and spread of antimicrobial resistance.
doi:10.1016/j.ijid.2008.05.953 fatcat:bdhvbdc7jzabbjjx2h4rk7gu7y