Prevalence, antibiotic susceptibility patterns, including ESBL production and associated risk factors of Klebsiella species among UTI suspected patients at Bahir-dar town, Northwest Ethiopia.

Abstract

Background Klebsiella species are opportunistic bacteria responsible for different infections such as pneumonia, urinary tract infections (UTI) and septicemia in nosocomial and community environments. Beta-lactam drugs are used extensively to treat patients with Klebsiella infections. But today, most Klebsiella species are resistance to third- and fourth-generation cephalosporins and monobactams.Objectives To assess the prevalence, antibiotic susceptibility patterns including ESBL production and associated risk factors of Klebsiella species among UTI suspected patients attended at Bahir Dar town health institutions, Northwest Ethiopia.Methods Institutional based cross-sectional study was conducted at Bahir Dar town health institutions from January to May 2019. A simple random sampling technique was used to enroll 384 study participants. Midstream urine samples were collected and inoculated onto Cystine–lactose–electrolyte-deficient and MacConkey agars. Identification was carried out by using biochemical tests. Antimicrobial susceptibility patterns of the isolates were determined by Disc-diffusion method. ESBL-producing Klebsiella species was detected by using combined and single antibiotic disks on Mueller Hinton agar. A statistical analysis was done using SPSS version 20 statistical package. P-value < 0.05 was considered as statistically significant with 95% confidence interval.Result Out of 385 study subjects, prevalence of Klebsiella species was 38(9.9%), of them 25(65.8%) were Klebsiella pneumonia, 4(10.5%) K. oxytoca, 6(15.8%) K. ozaenae and 3(7.9%) K. rhinoscleromatis species. Moreover; 22(57.9%) of isolates were from female participants. A multi-variable logistic regression analysis showed that pervious antibiotic use, history of hospitalization and habit of tight dressing were statistically significant for getting UTI 2.618 (AOR = 2.618, 95% CI = 1.18–6.129), 5.873 (AOR = 5.873, 95% CI = 2.355–14.6) and 15.038 (AOR = 15.038, 95% CI = 1.7–139) times more at risk respectively.Conclusions The overall prevalence of UTI was lower than the previous studies conducted in Ethiopia. High ESBL producing Klebsiella species was detected. Pervious antibiotic use, history of hospitalization and habit of tight closing were significant risk factors for UTI. This result calls up for improving of the prevention and control system of Klebsiella species.

Antibiogram of Klebsiella pneumoniae that isolated from clinical and environmental samples in Al-Diwaniyah hospitals

“…Whereas, bacteria showed a resistance rate of 75% in a study conducted by (58) in Iran. The isolates showed sensitivity to Chloramphenicol, and the resistance rate reached 25.71%, and it agreed with the results (9) . Because chloramphenicol has side effects and toxicity and the availability of safer alternatives chloramphenicol use is limited.…”

Prevalence of phenotypic multi-drug resistant Klebsiella species recovered from different human specimens in Ethiopia: A systematic review and meta-analysis

“…Article from 6 regions (Amhara, SNNPR, Sidama, Harari, Tigray, Somali) and one federal city Addis Ababa) met the criteria. A total of 40 articles that were published from 2018-2022 identified for the study, including 19 articles from Amhara region [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38], 7 articles from Addis Ababa [39][40][41][42][43][44][45], 5 articles from SNNPR [46][47][48][49][50], 3 articles from Sidama [51][52][53], 3 articles from Harari [54][55][56], 2 articles from Tigray [57,58]…”