SUSCEPTIBILITY OF PSEUDOMONAS-AERUGINOSA AND KLEBSIELLA SPP TO CEFTAZIDIME - CURRENT STATUS IN FRANCE

Abstract

Ceftazidime was tested against 2,224 strains of Pseudomonas aeruginosa obtained from 17 hospitals in April, May and June, 1986 and against 607 strains of Klebsiella pneumoniae and 234 strains of K. oxytoca obtained from 16 hospitals in October, 1987. The MIC''s of ceftazidime against P. aeruginosa were distributed normally, with an MIC50 of 2 mg/l and an MIC90 of 4 mg/l. Depending on critical concentrations, 80 per cent of strains were sensitive, 11.4 per cent were of intermediate sensitivity and 0.54 per cent were resistant. There were few differences in results between hospitals. Ninety-two per cent of resistant strains and 45 per cent of intermediate strains (as opposed to 6 per cent of all strains) produced a high-level constitutive cephalosporinase with little variations between centres. The MIC''s of ceftazidime against K. pneumoniae and K. oxytoca had a bimodal distribution: 91 per cent of strains were sensitive to 0.25 mg/l, 6 per cent of strains showed intermediate sensitivity and 3 per cent were resistant. All intermediate and resistant strains produced a very broad spectrum beta-lactamase which hydrolyzed some of the third generation cephalosporins: K. pneumoniae 36 CTX-1, 5 SHV-2, and 14 strains producing a recently identified beta-lactamase "CAZ-5/SHV-4"; K. oxytoca 3 CTX-1. These strains were isolated in 10 of the 16 hospitals which took part in the 1987 study. Comparison of these results with those of studies performed in 1984 and 1985 showed a moderate increase in the number of intermediate sensitivity strains of P. aeruginosa and the occasional occurrence, of the epidemic type, in some hospitals of Klebsiella spp. producing very broad spectrum beta-lactamases which were rare in 1985.