Risk factors for acquisition of extended-spectrum beta-lactamase producingKlebsiella infections

We set out to determine risk factors contributing to the development of res istance in Klebsiella infections caused by extended spectrum beta-lactamase (ESBL) producing strains. We reviewed the medical records of 33 patients f rom whom ESBL producing Klebsiella pneumoniae was isolated in any culture. The mean age was 12 months (1 day-8 years) and 20 of the 33 were boys. Of t he 37 isolates of ESBL-producing K. pneumoniae, the site of isolation was u rine in 17, cerebrospinal fluid in eight and blood in two cases. 28 of the patients were hospitalized and 22 had been admitted to the hospital in the past. All except one were being treated with antibiotics, third generation cephalosporins in 26 cases. The risk of acquisition of a resistant strain w as high if the period of hospitalization exceeded 10 days. We conclude that isolation of multiresistant organisms should be expected in children with a history of previous admission to hospital or with a prolonged stay in hos pital. The widespread use of extended spectrum antibiotics contributes to t he emergence of resistance. Med Sci Res 27:407-408 (C) 1999 Lippincott Will iams & Wilkins.