Prevalence and antimicrobial susceptibility of extended-spectrum â- lactamase- producing klebsiella pneumonia at a microbiology diagnostic center in Kashmir

Objective: To determine the prevalence and antimicrobial susceptibility of extended- spectrum â-lactamase (ESBL) producing Klebsiella pneumoniae isolated from different clinical specimens. Method: A total of 144 (10.2%) isolates of Klebsiella pneumoniae were recovered from 1409 different clinical specimens like urines, wound swabs, sputum, and blood at Al-Haram Diagnostic, Research and Training Center, Kashmir, India over a period of 24 months from December, 2005 to November, 2007. All these isolates were tested for ESBL production. Results: Of 144 isolates of K. pneumoniae, eighteen (12.5%) were positive for ESBL production. Most ESBL producers (50%) werefrom urines, followed by infected wounds (22.2%), sputum (16.7%) and blood (11.1%). ESBL producing strains of K. pneumoniae showed the highest susceptibility to imipenem (∼89%). The non â-lactam antibiotics with greatest activity against these ESBL strains were ciprofloxacin (72%), amikacin (66%), tobramycin (61%) and gentamicin (50%). Conclusions: Our findings demonstrate a high percentage of ESBL producers among clinical isolates of K. pneumoniae and a high rate of multidrug resistance. Two (11.1%) of strains of ESBL producing K. pneumoniae were resistant to imipenem. Therefore, regular monitoring of imipenem sensitivity and routine testing of newer carbapenems like meropenem and ertapenem should be carried out further.