Resistencia a gentamicina, amikacina y ciprofloxacina en cepas hospitalarias de Klebsiella pneumoniae subespecie pneumoniae productoras de -lactamasas de espectro extendido Resistance to gentamicin, amikacin and ciprofloxacin among nosocomial isolates of Klebsiella pneumoniae subspecie pneumoniae producing extended spectrum -lactamases

Background: Klebsiella pneumoniae is a pathogenic bacterium frequently isolated from nosocomial samples, specially the subspecie pneumoniae, with extensive antibiotic resistance profiles, including third generation cephalosporins, aminoglycosides and quinolones. This is specially true for those strains producing extended spectrum beta lactamases (ESBL). Aim: To investigate the susceptibility to gentamicin, amikacin and ciprofloxacin and the presence of some aminoglycoside modifying enzyme (AMEs) among nosocomial strains of K pneumoniae subspecie pneumoniae producing ESBL. Material and methods: The antibiotic resistant patterns and the level of resistance (minimal inhibitory concentration, MIC) of 100 strains, isolated from several hospitals of different Chilean cities, were determined. The presence of some aminoglycosides modifying enzyme (AMEs) was investigated by PCR. Results: Sixty five percent of strains were resistant to gentamicin, 47% were resistant to amikacin and 29% were resistant to ciprofloxacin. The most frequent AMEs genes detected were the aac(6')-Ib gene (6'-N-Acetyltransferase type Ib enzyme) in 69% of strains, conferring resistance to amikacin, kanamycin, tobramycin, and neomycin, and the gene aac(3)-IIa (3-Acetyltransferase type 3-IIa enzyme), in 36% of strains, conferring resistance to gentamicin. Conclusions: Among nosocomial strains of K pneumoniae subspecie pneumoniae isolated from Chilean hospitals, there is an association between the production of ESBL and the resistance to others antimicrobial agents, especially aminoglycosides. Nevertheless, 71% of isolates are susceptible to ciprofloxacin (Rev Méd Chile 2004; 132: 1173-8)