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• W2315691828 abstract "Ceftriaxone-resistant Klebsiella associated with multiple antimicrobial resistance is an increasing problem worldwide, particularly in tertiary referral hospitals. Appropriate laboratory procedures are required to detect extended- spectrum beta-lactamases. In this paper, the susceptibility testing criteria given in the NCCLS disc diffusion method is examined. The associated antimicrobial resistance of strains isolated in our laboratory is described. The distribution and prevalence of resistant strains in our hospital is presented. Selected Klebsiella isolates in our laboratory were tested by the NCCLS disc diffusion method (modified Bauer-Kirby) and by the Augmentin disc approximation test to screen for extended-spectrum beta-lactamases. The distribution of zone sizes were plotted. Representative MICs were determined by the E test. Records of Klebsiella isolations from 1 to 15 March 1994 were traced from the laboratory information system. 59/60 “resistant”, 23/23 “intermediate” and 5/56 “sensitive” strains identified by the NCCLS method were positive by the Augmentin disc approximation test. Intermediate strains formed a microbial population distinct from sensitive strains and had MICs 10-100× higher than sensitive strains. It is recommended that strains identified as “intermediate” on testing by the NCCLS method be regarded as resistant. 40% of Klebsiella isolates were ceftriaxone-resistant. Gentamicin resistance was strongly associated with ceftriaxone resistance, being found in 4/112 (3.6%) of ceftriaxone-sensitive strains and in 52/74 (70.3%) of ceftriaxone-resistant strains. Trimethoprim-sulfa(25% vs. 59%) and tetracycline(13.8% vs. 51.8%) resistance were also associated with ceftriaxone resistance. Ceftriaxone resistant strains were widely distributed throughout the hospital in all clinical disciplines, and predominated over sensitive strains in neurosurgical, haematology and intensive care units. Ceftriaxone-resistant Klebsiella associated with multiple antimicrobial resistance is an increasing problem worldwide, particularly in tertiary referral hospitals. Appropriate laboratory procedures are required to detect extended- spectrum beta-lactamases. In this paper, the susceptibility testing criteria given in the NCCLS disc diffusion method is examined. The associated antimicrobial resistance of strains isolated in our laboratory is described. The distribution and prevalence of resistant strains in our hospital is presented. Selected Klebsiella isolates in our laboratory were tested by the NCCLS disc diffusion method (modified Bauer-Kirby) and by the Augmentin disc approximation test to screen for extended-spectrum beta-lactamases. The distribution of zone sizes were plotted. Representative MICs were determined by the E test. Records of Klebsiella isolations from 1 to 15 March 1994 were traced from the laboratory information system. 59/60 “resistant”, 23/23 “intermediate” and 5/56 “sensitive” strains identified by the NCCLS method were positive by the Augmentin disc approximation test. Intermediate strains formed a microbial population distinct from sensitive strains and had MICs 10-100× higher than sensitive strains. It is recommended that strains identified as “intermediate” on testing by the NCCLS method be regarded as resistant. 40% of Klebsiella isolates were ceftriaxone-resistant. Gentamicin resistance was strongly associated with ceftriaxone resistance, being found in 4/112 (3.6%) of ceftriaxone-sensitive strains and in 52/74 (70.3%) of ceftriaxone-resistant strains. Trimethoprim-sulfa(25% vs. 59%) and tetracycline(13.8% vs. 51.8%) resistance were also associated with ceftriaxone resistance. Ceftriaxone resistant strains were widely distributed throughout the hospital in all clinical disciplines, and predominated over sensitive strains in neurosurgical, haematology and intensive care units." @default.
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• W2315691828 date "1995-01-01" @default.
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• W2315691828 title "Ceftriaxone-resistant Klebsiella in Singapore: prevalence, associated resistance and recommendations for testing" @default.
• W2315691828 doi "https://doi.org/10.1016/s0031-3025(16)35351-x" @default.
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