Abstract
Seven hundred and sixty-nine Klebsiella strains were isolated between 1976 and 1981 from adult patients of the Black Lion Teaching Hospital, Addis Ababa: 623 from inpatient and 146 from out-patient specimens; 46% from urine, 23% from pus, 20% from sputum, 4% from blood and 7% from other miscellaneous speimens. Over 70% were resistant to ampicillin, carbenicillin, chloramphenicol, streptomycin, shlphadiazine or tetracycline. Gentamicin, polymyxin B, trimethoprim-sulphamethoxazole, kanamycin and cephalothin were the more effective antimicrobial agents. Of the urinary isolates, 10% were resistant to nalidixic acid and 33% to nitrofurantoin. Resistance to 3 or more antibiotics was detected in 85% of isolates. There was no marked difference between resistance rates in in-patient and out-patient strains, but greatly varied resistance antibiograms were detected: 150 types among in-patient strains and 88 among out-patient strains. Only 13 types accounted for over 55% of the antibiograms in in-patient strains, but no such frequent antibiograms were detected among the out-patient isolates. The findings clearly reflected the consequence of a high rate of inappropriate usage of antimicrobial agents in this hospital, underscoring the need for a policy of better therapeutic practice.