Objective: Isolation of bacteria from blood culture plates is usually indicative of a serious invasive infection which requires an urgent antimicrobial therapy. Bacteremia and sepsis have high mortality and morbidity rates. In general, gram negative bacteria are the predominant cause of neonatal sepsis and among them, Klebsiella pneumoniae is the most common pathogen especially in developing countries. Microorganisms isolated from patients usually have different antimicrobial susceptibilities. Hence, successful treatment depends on prompt administration of appropriate antimicrobials. Treatment of hospital-acquired infections caused by K. pneumoniae may be difficult because many strains are highly resistant to many broad-spectrum antimicrobials. The aim of this study is to determine antimicrobial susceptibilities of Klebsiella strains isolated from blood cultures, and to assess the most effective empirical antimicrobial therapy for our hospital-acquired Klebsiella infections.

Material and Methods: In the present study, clinical Klebsiella strains isolated from various clinics of Konya Training and Research Hospital between January 2009 and December 2013 were used. Bacterial identification and antimicrobial susceptibility tests were performed by using conventional methods and Phoenix system (Becton Dickinson Sparks, USA).

Results: One hundred and seventy- nine Klebsiella strains isolated from blood cultures were included in the study. The most frequently isolated strain was K. pneumoniae spp (n=158; 88.2%). The detection rate of extended spectrum beta lactamase (ESBL) producing Klebsiella spp was 54.18%. Ertapenem (98.53%) was the most effective antimicrobial against Klebsiella isolates followed by meropenem (97.17%), imipenem (94.70%), and amikacin (93.74%).

Conclusion: Since the rate of ESBL producing strains was quite high, beta lactam antibiotics should not be preferred for the empirical treatment of hospital-acquired Klebsiella infections. In conclusion, as a vital issue each hospital should determine its own antimicrobial susceptibility patterns for the selection of the most optimal empirical antimicrobial therapy.