Epidemiological study of Klebsiella spp. uropathogenic strains producing extended-spectrum β-lactamase in a Tunisian university hospital, 2009 | Epidémiologie des souches de Klebsiella spp. uropathogènes productrices de β-lactamases à spectre élargi dans un hôpital universitaire Tunisien, 2009
2012
Ben Haj Khalifa, A. | Khedher, M.
OBJECTIVE: An update on the prevalence of antibiotic resistance in extended-spectrum β-lactamase among urinary strains of Klebsiella spp. isolated from in-come and out-come patients at University Hospital, Mahdia (Tunisia). PATIENTS AND METHODS: A retrospective survey was made over a period of twelve months (year 2009). It focused on 3564 patients with urinary tract infection confirmed by the Laboratory of Microbiology in the University Hospital, Mahdia. RESULTS: Klebsiella spp. was involved in 5.5% (198/3564) of all cases of urinary tract infections identified. Klebsiella pneumoniae accounted for 94.9% of all Klebsiella (5.1% for Klebsiella oxytoca). The frequency of Klebsiella spp. resistance to fluoroquinolones was 19.2% and to third generation cephalosporins was 22.7%. Forty strains of Klebsiella spp. producing extended-spectrum β-lactamase witch corresponds to 20.2% of all the Klebsiella. The extended-spectrum β-lactamase strains with resistance to fluoroquinolones were 67.5% (27/40) or 13.6% of all klebsiella (27/198). No strain was resistant to imipenem. The 27 strains multiresistant (ESBL+FQ resistance) are likely to be carriers of plasmids encoding the ESBL and resistance to fluoroquinolones. CONCLUSION: the resistance of Enterobacteriaceae, including Klebsiella spp, to fluoroquinolones has become a concern both in hospital in community medicine. The advent of this resistance mechanism involves a more rational use of fluoroquinolones, especially as first-line treatment of urinary tract infections.
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