Extended spectrum beta-lactamases in Escherichia coli and Klebsiella spp. from Eastern Romania

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Background: The emergence and dissemination of ESBL are problems of major importance for the population health; ESBLs represent a first example of factor that contribute to the global crisis concerning the treatment of Klebsiella pneumoniae and Escherichia coli against which the third generation cephalosporins are not efective anymore.

Methods: Clinically isolates of E. coli (n= 642) and Klebsiella (n=92) were collected from patients with different types of infections (sepsis, urinary tract infections, etc), hospitalyzed between september 08 and september 09 in a Hospital of Infectious Diseses from Eastern Romania. Double disc synergy test using cefotaxime and amoxicillin/clavulanic acid discs was used to screen ESBL producers and these strains were subsequently subjected to confirmatory Etest.

Results: E. coli resistance to cefotaxime, ceftazidime, cefoxitin, ciprofloxacin and imipenem was found to be 40, 29, 6, 30 and 1% respectively. Klebsiella resistance to cefotaxime, ceftazidime, cefoxitin, ciprofloxacin and imipenem was 70, 57, 22, 41 and 4% respectively. % of ESBL producers E. coli was 15% (97 strains) and Klebsiella was 38% (35). All the ESBL producing strains were susceptible in 100% to imipenem and meropenem.

Conclusion: Carbapenems remain the most active agents against Gram-negative isolates, including ESBL producers strain of E. coli and Klebsiella spp. isolated from communityacquired and nosocomial infections from Eastern Romania.