ISSN: 1859 - 2872
The value of antibiotic resistant genotype to predict cephalosporin resistance of Klebsiella pneumoniae causing blood stream infections
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Abstract
Summary
Objective: To evaluate the value of antibiotic resistant genotype to diagnose cephalosporin resistance of K. pneumoniae causing blood stream infections. Subject and method: A total of 50 K. pneumoniae septic patients were treated at 108 Military Central Hospital (108 MCH), in Hanoi, from October 2014 to May 2016. All strains were identified and determined antibiotic resistance by using Vitek II Automated system (BioMerieux, France). Genes producing ESBLs and carbapenemases were screened using in-house Multiplex PCR in Vietnamese-German Center for Medical Research, 108 MCH. Result: In total, the percentage of ESBLs producing K. pneumoniae was 22.0%. Cefotaxime, ceftazidime and cefepime resistant strains were 54.0%, 48.0% and 29.2% respectively. The percentages of ESBL genes: TEM, SHV and CTX-M were 46.0%, 84.0% and 46.0%; respectively. 90.0% of all strains carried at least one of three genes and 38.0% carried all of three genes. The sensitivity and specificity of TEM and CTX-M to diagnose K. pneumoniae producing ESBLs were 90.0% and 66.7%, respectively. The sensitivity and specificity of CTX-M to diagnose broad spectrum cephalosporin resistance were 77.8 - 89.5% and 82.9 - 91.3%, respectively. Similar results were found of TEM with 74.1 - 78.9% and 75.9 - 87.0%, respectively. Conclusion: CTX-M and TEM were good candidates to predict phenotypic resistance of K. pneumoniae causing BSIs.
Keywords: Sepsis, cephalosporin resistance, K. pneumoniae, ESBL.
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References
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