Circulation in Italy of β-Lactamase-Producing Strains within the Major Groups of Bacterial Pathogens

A multicenter study was undertaken in Italy to assess the circulation of β-lactamase-producing organisms and their current incidence within the major groups of bacterial pathogens. Almost four thousand strains, all freshly isolated from clinical material, were examined at four centers serving different areas of Italy. Despite some significant center-to-center differences, this survey documented the occurrence of a large overall circulation of β-lactamase-producing organisms among clinical bacterial isolates. In particular, ampicillin resistance was recorded in one third to one half of the isolates of some Enterobacteriaceae, including Escherichia coli, Proteus, and Citrobacter species, and 80-90% of these resistant strains proved to be β-lactamase producers. Both ampicillin resistance and β-lactamase production were almost the rule in other Enterobacteriaceae, including Klebsiella, Enterobacter, and Serratia species. β-lactamase was also produced by about 80% of glucose-non-fermenting gram-negative bacteria and Aeromonas hydrophila strains, by all of the isolates of Branhamella catarrhalis manifesting ampicillin resistance (i.e. more than half the total number of isolates), and by about two thirds of the ampicillin-resistant Haemophilus strains (which accounted for 20-25% of all Haemophilus isolates examined). In contrast, no β-lactamase producers were observed among Neisseria gonorrhoeae isolates.