Antimicrobial Susceptibility Profile and Frequency of ESBL Gene Determinants among Klebsiella pneumoniae Isolates from Patients attending an Urban Secondary Health Facility in Nigeria

Olalekan AO(1), Babalola AB AB(2), Ogunleye OO(3), Opere B(4), Ekun OA(5), Ajani IO(6), Iwalokun BA(7),


(1) Department of Medical Laboratory Science, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
(2) Department of Medical Laboratory Science, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria. Medical Laboratory Science Unit, Alimosho General Hospital, Lagos, Nigeria.
(3) Department of Pharmacology, Therapeutics & Toxicology, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria. Department of Medicine, Lagos State University Teaching Hospital, Lagos, Nigeria
(4) Department of Microbiology, Lagos State University, Ojo, Lagos, Nigeria
(5) Department of Medical Laboratory Science, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria.
(6) Department of Medical Laboratory Science, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria.
(7) Molecular Biology & Biotechnology Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria. Central Research Laboratory, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
Corresponding Author

Abstract


Background: Klebsiella pneumoniae is one of the commonest aetiologies of infections associated with high mortality and morbidity in resource-limited countries such as Nigeria and globally. The incriminating K. pneumoniae strains often harbour ESBL gene determinants that are responsible for multi-drug resistance (MDR) infections, making treatments and patient care difficult. Profiling these resistance genes will help in evidence-based strategic planning to reduce the burden of community-acquired MDR K. pneumoniae in Nigeria.

Objective: To determine the antibiogram and the prevalence of ESBL genetic determinant in K. pneumoniae.

Methods: We collected non-duplicated 92 isolates of K. pneumoniae between March and May 2019 from the Medical Laboratory Units of a secondary health facility in Lagos, Nigeria. The isolates were identified using standard biochemical tests and Microbact 12E for Enterobacteriaceae. Antimicrobial susceptibility testing was performed using the disk diffusion method according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. The DNA was extracted using QIAamp DNA Mini Kit followed by multiplex amplification blaCTX-M, blaTEM, and blaSHV genes.

Results: The isolates were 100% resistant to ampicillin and piperacillin, 89% resistant to cefotaxime, ceftazidime and ciprofloxacin, 79.1% resistant to cefixime, 65.2% to gentamicin, 90.2% resistant to levofloxacin and trimethoprim/sulfamethoxazole. The MDR K. pneumoniae prevalence was 89% harbouring resistant genes as blaTEM/blaSHV 23 (28%), blaSHV/blaCTX-M/blaTEM 19 (23%), blaSHV 19 (23%), blaCTXM/blaTEM 12 (15%), blaCTX-M 7 (8.5%), blaCTX/blaSHV 2 (2.4%). blaSHV was the most common gene among all the isolates appearing singly and simultaneously with other genes.

Conclusion: The prevalence of MDR K. pneumoniae that harbours ESBL genes was high. Therefore, there is an urgent need for strategic infection prevention and control to optimise treatments and halt the transmission of MDR K. pneumoniae infections in this hospital.


Keywords


ESBL, MDR, Klebsiella pneumoniae, Resistance gene, blaSHV, blaCTX-M, blaTEM

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