Evolution of resistance of Klebsiella pneumoniae in Londrina University Hospital from 2000 to 2011

Abstract

The present study aimed to evaluate the evolution of antibiotic resistance in clinical isolates of Klebsiella pneumoniae in the period of 2000 to 2011, at the University Hospital of Londrina (HU-UEL). A retrospective analysis of 2,318 antimicrobial susceptibility tests of K. pneumoniae was performed from a database of the Clinical Laboratory of Microbiology of the University Hospital. In the period of 2000 to 2009, the main mechanism of resistance observed to ?-lactam antimicrobials was due to the production of ESBL ?-lactamase type (?-lactamase wide spectrum), which can be verified by the increased resistance of K. pneumoniae to 3rd generation cephalosporins and cefepime. However, the first strains of K. pneumoniae carbapenemase-producing appeared in 2009, compromising the efficacy of carbapenems. The rates of resistance to ertapenem ranged from 16%, in 2005, to 40% in 2011. Another class of committed antibiotics was the fluoroquinolones; for ciprofloxacin, resistance rates ranged from 13% to 62%, in 2001 and 2011, respectively. Aminoglycosides exhibited oscillations of resistance during the period studied, reaching, in 2011, values of 56% and 30% for gentamicin and amikacin, respectively. Meanwhile, trimethoprim/ sulfamethoxazole and piperacillin/tazobactam reached about 60%, in the same period. Therefore, knowing the antimicrobial resistance of K. pneumoniae strains is essential for proper treatment of patients and adoption of appropriate measures that aims infection control, and proper use of these drugs.