Journal of Antimicrobial Chemotherapy (2000) 45, 183-189
© 2000 The British Society for Antimicrobial Chemotherapy
Antimicrobial resistance amongst Klebsiella spp. collected from intensive care units in Southern and Western Europe in 1997–1998
Antibiotic Resistance Monitoring and Reference Laboratory, Central Public Health Laboratory, 61 Colindale Avenue, London NW9 5HT, UK
A 1994 survey of 35 intensive care units (ICUs) in Western and Southern Europe found extended-spectrum ß-lactamases (ESBLs) in 220/966 (23%) klebsiellae. A follow-up survey from May 1997 to October 1998 collected klebsiellae from 24 ICUs, including 23 that participated in 1994. Twenty-one ICUs sent 433 eligible isolates, of which 110 (25%) had ESBLs. The prevalence of ESBLs had not changed significantly from 1994 but the proportion of ESBL-producers resistant to piperacillin/tazobactam had risen from 31% to 63% (P < 0.001), and most of this resistance was high level (MICs 
128 + 4 mg/L). The proportion of Klebsiella oxytoca isolates hyperproducing K1 ß-lactamase rose from 8% in 1994 to 21% in 1997–1998 (P < 0.001). Most klebsiellae (99%) were very susceptible to meropenem (mode MIC 0.03 mg/L) but three had decreased susceptibility (MICs 2–4 mg/L). These could not hydrolyse carbapenems. Aminoglycoside resistance was not significantly changed in prevalence from 1994; ciprofloxacin resistance occurred in 31% of ESBL-producers in both years, but had increased among non-producers (2% in 1994 versus 7% in 1997–1998, P < 0.001).
* Corresponding author. Tel: +44-181-200-4400; Fax: +44-181-200-7449; E-mail: DLivermore{at}phls.nhs.uk
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