Beta-lactam resistance amongEscherichia coli andKlebsiella species blood culture isolates in Finnish hospitals

  • T. Arstila
  • H. Auvinen
  • P. Huovinen
  • the Finnish Study Group for Antimicrobial Resistance


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.


Internal Medicine Ampicillin Blood Culture Cephalosporin Cefuroxime 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Huovinen P, Grönroos P, Herva E, Katila M-L, Klossner M-L, Renkonen O-V, Toivanen P: Aminoglycoside resistance among blood culture isolates. Journal of Clinical Microbiology 1984, 20: 65–69.PubMedGoogle Scholar
  2. 2.
    Wiedemann B, Kliebe C, Kresken M: The epidemiology of β-lactamases. Journal of Antimicrobial Chemotherapy 1989, 24: 1–22.Google Scholar
  3. 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. 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
  5. 5.
    Rice LB, Willey SH, Papanicolaou GA, Medeiros AA, Eliopoulos GM, Moellering RC, Jacoby GA: Outbreak of ceftazidime resistance caused by extended-spectrum β-lactamases at a Massachusetts chronic-care facility. Antimicrobial Agents and Chemotherapy 1990, 34: 2193–2199.PubMedGoogle Scholar
  6. 6.
    Quinn JP: Novel plasmid-mediated extended spectrum beta-lactamases. Infectious Diseases Newsletter 1992, 11: 33–40.CrossRefGoogle Scholar
  7. 7.
    Gutmann L, Ferre B, Goldstein FW, Rizk N, Pinto-Schuster E, Acar JF, Collatz E: SHV-5, a novel SHV-type β-lactamase that hydrolyzes broad-spectrum cephalosporins and monobactams. Antimicrobial Agents and Chemotherapy 1989, 33: 951–956.PubMedGoogle Scholar
  8. 8.
    Jacoby GA, Medeiros AA: More extended-spectrum β-lactamases. Antimicrobial Agents and Chemotherapy 1991, 35: 1697–1704.PubMedGoogle Scholar
  9. 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
  10. 10.
    Huovinen S, Huovinen P, Jacoby GA: Detection of plasmid-mediated β-lactamases with DNA probes. Antimicrobial Agents and Chemotherapy 1988, 32: 175–179.PubMedGoogle Scholar
  11. 11.
    Feinberg AP, Vogelstein B: A technique for radiolabelling DNA restriction endonuclease fragments to high specific activity. Analytical Biochemistry 1983, 132: 6–13.CrossRefPubMedGoogle Scholar
  12. 12.
    Thompson KS, Sanders CC: Detection of extended-spectrum β-lactamases in members of the familyEnterobacteriaceae: comparison of the double-disk and three-dimensional tests. Antimicrobial Agents and Chemotherapy 1992, 36: 1877–1882.PubMedGoogle Scholar
  13. 13.
    Brun-Buisson C, Legrand P, Philippon A, Montravers F, Ansquer M, Duval J: Transferable enzymatic resistance to third-generation cephalosporins during nosocomial outbreak of multiresistantKlebsiella pneumoniae. Lancet 1987, ii: 302–306.CrossRefGoogle Scholar
  14. 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. 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
  16. 16.
    Katsanis G, Jacoby G: The frequency of extended-spectrum β-lactamases in isolates ofKlebsiella pneumoniae. Journal of Antimicrobial Chemotherapy 1992, 29: 345–353.PubMedGoogle Scholar
  17. 17.
    Noridc Council on Medicines: Nordic statistics on medicines 1987–1989. NNC Publciation 30. Nordiska Läkemedelsnämnden, Uppsala, Sweden, 1990.Google Scholar
  18. 18.
    Payne DJ, Amyes SGB: Transferable resistance to extended-spectrum β-lactams: a major threat or a minor inconvenience? Journal of Antimicrobial Chemotherapy 1991, 27: 255–261.PubMedGoogle Scholar
  19. 19.
    Sanders CC, Sanders WE: β-lactam resistance in gramnegative bacteria: global trends and clinical impact. Clinical Infectious Diseases 1992, 15: 824–839.PubMedGoogle Scholar
  20. 20.
    Woodford N, Payne DJ, Johnson AP, Weinbren MJ, Perinpanayagam RM, George RC, Cookson BD, Amyes SGB: Transferable cephalosporin resistance not inhibited by clavulanate inEscherichia coli. Lancet 1990, 336: 253.CrossRefGoogle Scholar
  21. 21.
    Papanicolaou GA, Medeiros AA, Jacoby GA: Novel plasmid-mediated β-lactamase (MIR-1) conferring resistance to oxyimino- and α-methoxy-β-lactams in clinical isolates ofKlebsiella pneumoniae. Antimicrobial Agents and Chemotherapy 1990, 34: 2200–2209.PubMedGoogle Scholar
  22. 22.
    Blazquez J, Baquero M-R, Canton R, Alos I Baquero F: Characterization of the new TEM-type β-lactamase resistant to clavulanate, sulbactam, and tazobactam in a clinical isolate ofEscherichia coli. Antimicrobial Agents and Chemotherapy 1993, 37: 2059–2063.PubMedGoogle Scholar

Copyright information

© Friedr. Vieweg & Sohn Verlagsgesellschaft mbH 1994

Authors and Affiliations

  • T. Arstila
    • 1
  • H. Auvinen
    • 2
  • P. Huovinen
    • 1
  • the Finnish Study Group for Antimicrobial Resistance
  1. 1.Antimicrobial Research LaboratoryNational Public Health InstituteTurkuFinland
  2. 2.Kanta-Häme Central HospitalHämeenlinnaFinland

Personalised recommendations