Beta-lactam resistance amongEscherichia coli andKlebsiella species blood culture isolates in Finnish hospitals
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The aim of this study was to investigate beta-lactam resistance inEscherichia coli andKlebsiella spp. blood culture isolates in Finland. Special attention was given to extended-spectrum beta-lactamases. A total of 566Escherichia coli and 108Klebsiella spp. blood culture isolates were collected from hospitals throughout Finland and their susceptibility to beta-lactam antibiotics studied. Twenty percent ofEscherichia coli and 69 % ofKlebsiella spp. strains were resistant to ampicillin. The mechanisms of resistance were studied by hybridization, isoelectric focusing and the clavulanate double-disk potentiation test. Of the ampicillin-resistantEscherichia coli strains, 83 % produced TEM-1. Of the ampicillin-resistantKlebsiella spp. strains, 43 % produced SHV-1. Only nineEscherichia coli and threeKlebsiella spp. isolates were resistant to cefuroxime (MIC ≥32 µg/ml), and none were resistant to third-generation cephalosporins. These data were compared with cefuroxime and third-generation cephalosporin consumption levels in Finnish hospitals. Although the use of cephalosporins is far more extensive in Finland than in other Scandinavian countries, none of the isolates produced extended-spectrum beta-lactamases. In conclusion, resistance to cefuroxime has remained rare in Finland, and cefuroxime is still an alternative to third-generation cephalosporins in the treatment of septicemia.
KeywordsInternal Medicine Ampicillin Blood Culture Cephalosporin Cefuroxime
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- 2.Wiedemann B, Kliebe C, Kresken M: The epidemiology of β-lactamases. Journal of Antimicrobial Chemotherapy 1989, 24: 1–22.Google Scholar
- 3.Arstila T, Huovinen S, Huovinen P: Analysis of beta-lactamase production in ampicillin-resistantEscherichia coli isolated from blood cultures 1983–1989. European Journal of Clinical Microbiology and Infectious Diseases 1991, 10: 1068–1070.Google Scholar
- 4.Huovinen S, Huovinen P, Torniainen K, Jacob GA: Evaluation of plasmid-encoded beta-lactamase resistance inEscherichia coli blood culture isolates. European Journal of Clinical Microbiology and Infectious Diseases 1988, 10: 651–655.Google Scholar
- 9.National Committee for Clinical Laboratory Standards: Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically. Approved standard M7-A2, NCCLS, Villanova, PA, 1990.Google Scholar
- 14.WHO Collaboration Centre for Drug Statistics Methology: Anatomical therapuetic chemical classification index including defined daily doses for plain substances. WHO, Oslo, Norway, 1992.Google Scholar
- 15.Reig R, Roy C, Hermida M, Teruel D, Coira A: A survey of β-lactamases from 618 isolated ofKlebsiella spp. Journal of Antimicrobial Chemotherapy 1993, 31: 29–35.Google Scholar
- 17.Noridc Council on Medicines: Nordic statistics on medicines 1987–1989. NNC Publciation 30. Nordiska Läkemedelsnämnden, Uppsala, Sweden, 1990.Google Scholar