Risk factors for acquisition of extended-spectrum beta-lactamase producing Klebsiella infections

Abstract

We set out to determine risk factors contributing to the development of resistance in Klebsiella infections caused by extended spectrum beta-lactamase (ESBL) producing strains. We reviewed the medical records of 33 patients from whom ESBL producing Klebsiella pneumoniae was isolated in any culture. The mean age was 12 months (1 day-8 years) and 20 of the 33 were boys. Of the 37 isolates of ESBL-producing K. pneumoniae, the site of isolation was urine in 17, cerebrospinal fluid in eight and blood in two cases. 28 of the patients were hospitalized and 22 had been admitted to the hospital in the past. All except one were being treated with antibiotics, third generation cephalosporins in 26 cases. The risk of acquisition of a resistant strain was high if the period of hospitalization exceeded 10 days. We conclude that isolation of multiresistant organisms should be expected in children with a history of previous admission to hospital or with a prolonged stay in hospital. The widespread use of extended spectrum antibiotics contributes to the emergence of resistance. Med Sci Res 27:407-408 (C) 1999 Lippincott Williams & Wilkins.