Antimicrobial Resistance Patterns and Molecular Characterization of <i>Klebsiella pneumoniae</i> in Clinical Isolates at Mbarara Regional Referral Hospital

Abstract

Background: Klebsiella pneumoniae is one of the most frequent opportunistic pathogens causing a range of infections and being resistant for beta-lactamases (ESBL) and Carbapenemases. Aim: The aim of the present study was to determine the antimicrobial resistance patterns and molecular characterization establishing the phenotypes and genotypes associated with drug resistance, an antibiogram of genotypically positive isolates for resistance of Klebsiella pneumoniae in clinical isolates at MRRH. Materials and Methods: A laboratory-based descriptive cross-sectional study that was conducted from September 2018 to May 2019 at MRRH. Klebsiella pneumoniae was identified by cultural and biochemical methods. Antibiotic sensitivity test was performed by modified Kirby-Bauer disc diffusion technique. ESBL production in Klebsiella pneumoniae was tested by double-disc synergy test, Carbapenemase production by MHT, Boronic Acid or EDTA test using Meropenem phenotypically and both resistance confirmed genotypically by Multiplex PCR. Results: Out of 1055 clinical isolates, 298 (28.2%) were found positive for Klebsiella.spp, 175 isolates were subcultured among which 22 (12.57%) were K. pneumoniae based on API 20E. Overall Sensitivity patterns of these Klebsiella pneumoniae isolates to Ceftriaxone, (Amoxicillin/Clavulanate), Gentamicin, Cefepime, Ciprofloxacin, Cefoxitin, Nitrofurantoin, Cefuroxime, piperacillin/tazobactam, Meropenem, Ceftazidime and cefotaxime were 72.7%,

Hypervirulent Klebsiella pneumoniae Endogenous Endophthalmitis—A Global Emerging Disease

“…Klebsiella pneumoniae (Kp) is a Gram-negative opportunistic bacterium, from the Enterobacteriaceae family, which classically produces lobar pneumonia, particularly in immunocompromised patients, and it is known to cause hospital-acquired pneumonia, meningitis, bloodstream, and urinary tract infections [ 1 , 2 ].…”

Molecular detection of carbapenem resistant Klebsiella pneumoniae isolated from clinical specimens in Jos, Nigeria

“…Urine sample has the highest source of K. pneumoniae in this study is suggestive of urinary tract infections and accounts for almost 40% of nosocomial infections [23]. More so, environmental pressure [15] has been noted as a factor that could be responsible for the variations observed in the recovery of K. pneumoniae from clinical specimens. Klebsiella is the most heat tolerant among all enteric pathogens [24], having maximal specific growth rate at 37˚C and are reported to survive at higher humidity [25].…”

“…This finding agrees with previous study by Olowo-okere et al [20] from Sokoto, Nigeria, where they isolated 292 Enterobacteriaceae including K. pneumoniae from clinical specimens and most were recovered from urine specimens [49.0%). Turugurwa et al [15] also reported highest (50.85%) Klebsiella recovery from urine samples irrespective of age and gender in Uganda. Similar findings from other investigators from Uganda reported that urine is the principal source of Klebsiella [21,22].…”

“…Lower rates of K. pneumonia were also reported elsewhere. Turugurwa et al [15] documented 28.0% prevalence in Mbarara, Uganda. Also, [16] and [17] respectively reported 20.26% and 12.70% prevalence of K. pneumoniae in Uganda.…”

“…Klebsiella is the most heat tolerant among all enteric pathogens [24], having maximal specific growth rate at 37˚C and are reported to survive at higher humidity [25]. Therefore, characteristics seasonalvariation influences recovery of Klebsiella, as during the warmest months there are increased reports of Klebsiella isolation from urine [15]. Antibiotic susceptibility pattern showed carbapenem resistance in 3 (37.50%)of the tested isolates.Isolates also showed high resistance to gentamicin (62.50%), ceftriaxone (50.00%), amoxicillin/clavulanic acid (62.50%), ciprofloxacin (37.50%), cefepime (62.50%) and clarithromycin (50.00%).…”