Molecular Detection and Antibiotic Susceptibility Profile of ESBL-producing Klebsiella pneumoniae Isolates in a Central Nigerian Tertiary Hospital

Background: Production of extended-spectrum β-lactamases (ESBLs) is the most common mechanism of resistance to third-generation cephalosporins among Enterobacteriaceae including Klebsiella pneumonia and this presents therapeutic challenges managing infections caused by these strains of bacteria. Aim: To determine the prevalence, antibiotic susceptibility profile and major ESBL encoding genes among Klebsiella pneumoniae in clinical specimens. Methods: Four hundred (400) consecutive and non-duplicate isolates of Klebsiella pneumoniae from clinical specimens were identified by standard laboratory methods at the National Hospital Abuja, subjected to antimicrobial susceptibility testing using the Kirby-Bauer disc diffusion method and identified ESBL phenotypes were confirmed using E-test. Multiplex PCR was used to detect ESBL genes. Results: Out of the 400 Klebsiella pneumoniae isolates, 114 (28.5%) were ESBL producers, out of which 111 (97.4%) were sensitive to meropenem, 101 (88.6%) to amikacin, 100 (87.7%) to fosfomycin, 96 (84.2%) to tigecycline, and 58 (50.9%) to nitofurantoin. All the ESBL producers were resistant to cefotaxime while 107 (93.9%) and 105 (92.1%) were resistant to amoxicillin-clavulanate, and ceftazidime respectively . There was a significantly higher distribution of multidrug resistance among ESBL producing isolates compared to non-ESBL producing isolates (chi-square =63.29, p-value = 0.0001). The distribution showed that 78 (70.3%) had the blaSHV gene, 99 (89.2%) had the blaCTX-M gene, 88 (79.3%) had the blaTEM gene and 3 (2.6%) had none of the major bla genes. Conclusion: This study showed a relatively high prevalence of ESBL-producing Klebsiella pneumoniae isolates and a significant occurrence of multidrug-resistant Klebsiella pnuemoniae. Meropenem and amikacin are excellent therapeutic choices for empirical therapy of ESBL-producing Klebsiella pneumoniae infections and their use should be properly guarded through efficient infection control and antimicrobial stewardship. Read more
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Molecular Detection and Antibiotic Susceptibility Profile of ESBL-producing Klebsiella pneumoniae Isolates in a Central Nigerian Tertiary Hospital

Background: Production of extended-spectrum β-lactamases (ESBLs) is the most common mechanism of resistance to third-generation cephalosporins among Enterobacteriaceae including Klebsiella pneumonia and this presents therapeutic challenges managing infections caused by these strains of bacteria. Aim: To determine the prevalence, antibiotic susceptibility profile and major ESBL encoding genes among Klebsiella pneumoniae in clinical specimens. Methods: Four hundred (400) consecutive and non-duplicate isolates of Klebsiella pneumoniae from clinical specimens were identified by standard laboratory methods at the National Hospital Abuja, subjected to antimicrobial susceptibility testing using the Kirby-Bauer disc diffusion method and identified ESBL phenotypes were confirmed using E-test. Multiplex PCR was used to detect ESBL genes. Results: Out of the 400 Klebsiella pneumoniae isolates, 114 (28.5%) were ESBL producers, out of which 111 (97.4%) were sensitive to meropenem, 101 (88.6%) to amikacin, 100 (87.7%) to fosfomycin, 96 (84.2%) to tigecycline, and 58 (50.9%) to nitofurantoin. All the ESBL producers were resistant to cefotaxime while 107 (93.9%) and 105 (92.1%) were resistant to amoxicillin-clavulanate, and ceftazidime respectively . There was a significantly higher distribution of multidrug resistance among ESBL producing isolates compared to non-ESBL producing isolates (chi-square =63.29, p-value = 0.0001). The distribution showed that 78 (70.3%) had the blaSHV gene, 99 (89.2%) had the blaCTX-M gene, 88 (79.3%) had the blaTEM gene and 3 (2.6%) had none of the major bla genes. Conclusion: This study showed a relatively high prevalence of ESBL-producing Klebsiella pneumoniae isolates and a significant occurrence of multidrug-resistant Klebsiella pnuemoniae. Meropenem and amikacin are excellent therapeutic choices for empirical therapy of ESBL-producing Klebsiella pneumoniae infections and their use should be properly guarded through efficient infection control and antimicrobial stewardship. Read more
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Molecular Detection and Antibiotic Susceptibility Profile of ESBL-producing Klebsiella pneumoniae Isolates in a Central Nigerian Tertiary Hospital

Background: Production of extended-spectrum β-lactamases (ESBLs) is the most common mechanism of resistance to third-generation cephalosporins among Enterobacteriaceae including Klebsiella pneumonia and this presents therapeutic challenges managing infections caused by these strains of bacteria. Aim: To determine the prevalence, antibiotic susceptibility profile and major ESBL encoding genes among Klebsiella pneumoniae in clinical specimens. Methods: Four hundred (400) consecutive and non-duplicate isolates of Klebsiella pneumoniae from clinical specimens were identified by standard laboratory methods at the National Hospital Abuja, subjected to antimicrobial susceptibility testing using the Kirby-Bauer disc diffusion method and identified ESBL phenotypes were confirmed using E-test. Multiplex PCR was used to detect ESBL genes. Results: Out of the 400 Klebsiella pneumoniae isolates, 114 (28.5%) were ESBL producers, out of which 111 (97.4%) were sensitive to meropenem, 101 (88.6%) to amikacin, 100 (87.7%) to fosfomycin, 96 (84.2%) to tigecycline, and 58 (50.9%) to nitofurantoin. All the ESBL producers were resistant to cefotaxime while 107 (93.9%) and 105 (92.1%) were resistant to amoxicillin-clavulanate, and ceftazidime respectively . There was a significantly higher distribution of multidrug resistance among ESBL producing isolates compared to non-ESBL producing isolates (chi-square =63.29, p-value = 0.0001). The distribution showed that 78 (70.3%) had the blaSHV gene, 99 (89.2%) had the blaCTX-M gene, 88 (79.3%) had the blaTEM gene and 3 (2.6%) had none of the major bla genes. Conclusion: This study showed a relatively high prevalence of ESBL-producing Klebsiella pneumoniae isolates and a significant occurrence of multidrug-resistant Klebsiella pnuemoniae. Meropenem and amikacin are excellent therapeutic choices for empirical therapy of ESBL-producing Klebsiella pneumoniae infections and their use should be properly guarded through efficient infection control and antimicrobial stewardship. Read more
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Molecular Detection and Antibiotic Susceptibility Profile of ESBL-producing Klebsiella pneumoniae Isolates in a Central Nigerian Tertiary Hospital

Background: Production of extended-spectrum β-lactamases (ESBLs) is the most common mechanism of resistance to third-generation cephalosporins among Enterobacteriaceae including Klebsiella pneumonia and this presents therapeutic challenges managing infections caused by these strains of bacteria. Aim: To determine the prevalence, antibiotic susceptibility profile and major ESBL encoding genes among Klebsiella pneumoniae in clinical specimens. Methods: Four hundred (400) consecutive and non-duplicate isolates of Klebsiella pneumoniae from clinical specimens were identified by standard laboratory methods at the National Hospital Abuja, subjected to antimicrobial susceptibility testing using the Kirby-Bauer disc diffusion method and identified ESBL phenotypes were confirmed using E-test. Multiplex PCR was used to detect ESBL genes. Results: Out of the 400 Klebsiella pneumoniae isolates, 114 (28.5%) were ESBL producers, out of which 111 (97.4%) were sensitive to meropenem, 101 (88.6%) to amikacin, 100 (87.7%) to fosfomycin, 96 (84.2%) to tigecycline, and 58 (50.9%) to nitofurantoin. All the ESBL producers were resistant to cefotaxime while 107 (93.9%) and 105 (92.1%) were resistant to amoxicillin-clavulanate, and ceftazidime respectively . There was a significantly higher distribution of multidrug resistance among ESBL producing isolates compared to non-ESBL producing isolates (chi-square =63.29, p-value = 0.0001). The distribution showed that 78 (70.3%) had the blaSHV gene, 99 (89.2%) had the blaCTX-M gene, 88 (79.3%) had the blaTEM gene and 3 (2.6%) had none of the major bla genes. Conclusion: This study showed a relatively high prevalence of ESBL-producing Klebsiella pneumoniae isolates and a significant occurrence of multidrug-resistant Klebsiella pnuemoniae. Meropenem and amikacin are excellent therapeutic choices for empirical therapy of ESBL-producing Klebsiella pneumoniae infections and their use should be properly guarded through efficient infection control and antimicrobial stewardship. Read more
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