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Antimicrobial use prior as a risk factor for developing extended-spectrum beta-lactamse-producing Klebsiella spp. in South Brazil

  • 1,
  • 2,
  • 1,
  • 3,
  • 4,
  • 5 and
  • 2
BMC Proceedings20115 (Suppl 6) :P138

  • Published:


  • Cephalosporin
  • Metronidazole
  • Electronic Medical Record
  • Disk Diffusion
  • Retrospective Case

Introduction / objectives

Extended-spectrum beta-lactamase-producing (ESBL) Klebsiella spp. is a problematic nosocomical pathogen around the world. In the present study, we aimed to evaluate the previous use of antibiotics as a risk factor for isolation of ESBL Klebsiella spp.


In a retrospective case control study between June 2009 and June 2010 at Santa Casa de Misericórdia Hospital, city of Ponta Grossa, south Brazil, 61 Klebsiella spp. (29 ESBL and 32 controls non-ESBL-producing isolates) were enrolled. ESBL were screened by disk diffusion method and double disk approximation method, according to CLSI. Prior use of antibiotic was analyzed in electronic medical records. The antibiotic consumption (DDDs – defined daily doses) was tested using the X2 test (p <0.05).


The DDDs of prior use and full use of cephalosporines, fluoroquinolones, e metronidazole in ESBL and non-ESBL groups were (122.02/145.77; 8.78/69.07), (15.66/22; 0.01/26.2), (47.33/47.66; 3/28) respectively. Prior use of cephalosporines, fluoroquinolones, and metronidazole was higher in ESBL-Klebsiella spp. than non-ESBL-Klebsiella spp. (p<0,001). Carbapenems were not used by the control group.


Theprior use of broad-spectrum cephalosporins, fluoroquinolones and metronidazole is an important risk factor for acquisition of ESBL producing Klebsiella spp.

Disclosure of interest

None declared.

Authors’ Affiliations

Departamento de Medicina, Universidade Estadual de Ponta Grossa, Ponta Grossa, Brazil
Análises Clínicas e Toxicológicas, Universidade Estadual de Ponta Grossa, Ponta Grossa, Brazil
Departamento de Saúde Pública, Universidade Estadual de Ponta Grossa, Ponta Grossa, Brazil
Intensive Care Unit, Santa Casa de Misericórdia, Ponta Grossa, Brazil
Pharmacy, Santa Casa de Misericórdia, Ponta Grossa, Brazil


© Ostroski et al; licensee BioMed Central Ltd. 2011

This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.