Prevalence and Pattern of Extended Spectrum Beta-Lactamases (ESBL) Producing Klebsiella pneumoniae in Biological Specimen at a Tertiary Hospital
A. A. Jonah *
Department of Medical Microbiology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
O. K. Obunge
Department of Medical Microbiology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
K. T. Wariso
Department of Medical Microbiology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Aim: The study was carried out to assess the distribution and pattern of ESBL producing Klesbsiella pneumoniae in specimen analysed at the Microbiology laboratory of a tertiary healthcare center.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Medical Microbiology, University of Port Harcourt Teaching Hospital, Rivers state, Nigeria carried out between January 2019 to June 2019
Methods: Clinical specimen including blood, wound biopsy/aspirate, urine and sputum specimens were collected and processed according to standard methods. Blood agar, Cysteine Lactose Electrolyte Deficient agar (CLED) and MacConkey agar were used to culture the specimens to isolate K. pneumoniae. A confirmatory test was carried out on all suspected ESBL isolates using combination disks according to the CLSI guidelines.
Results: The study reports a prevalence rate of 34.7% (118/340) for ESBL-production among K. pneumoniae isolates in UPTH, Port Harcourt. Blood culture was found to have the highest proportion of ESBL K. pneumoniae (57.1%) while urine samples had the least proportion of ESBL K. pneumoniae growth (32.5%). There was no significant distribution of ESBL K. pneumoniae growth by age groups or gender among the patients sampled. However, the occurrence of ESBL K. pneumoniae was higher among in-patients (37.0%) compared to outpatients (28.7%).
Conclusion: The growth of ESBL K. pneumoniae was observed to be higher among inpatient subject indicative of the likelihood of high prevalence ESBL K. pneumoniae in hospital acquired infection. Therefore, there is a great need for urgent interventions in the areas of antimicrobial usage and infection prevention and control in our settings.
Keywords: Antibiotics, prevalence, extended spectrum beta-lactamase, klebsiella pneumoniae
How to Cite
Downloads
References
Tanko N, Bolaji RO, Olayinka AT, et al. A systematic review on the prevalence of extended-spectrum beta lactamase-producing Gram-negative bacteria in Nigeria. J Glob Antimicrob Resist. 2020;22: 488–496.
Ferreira RL, Da Silva BCM, Rezende GS, et al. High prevalence of multidrug-resistant klebsiella pneumoniae harboring several virulence and β-lactamase encoding genes in a brazilian intensive care unit. Front Microbiol; 10. Epub Ahead of Print; 2019. DOI: 10.3389/FMICB.2018.03198/FULL.
Davido B, Batista R, Dinh A, et al. Fifty shades of graft: How to improve the efficacy of faecal microbiota transplantation for decolonization of antibiotic-resistant bacteria. Int J Antimicrob Agents. 2019;53:553–556.
Adzitey F, Assoah-Peprah P, Teye GA. Whole-genome sequencing of Escherichia coli isolated from contaminated meat samples collected from the Northern Region of Ghana reveals the presence of multiple antimicrobial resistance genes. J Glob Antimicrob Resist. 2019; 18:179–182.
Mohammed Y, Gadzama GB, Zailani SB, et al. Characterization of extended-spectrum beta-lactamase from Escherichia coli and Klebsiella species from North Eastern Nigeria. J Clin Diagnostic Res. 2016;10:DC07-DC10.
Ramirez MS, Traglia GM, Lin DL, et al. Plasmid-Mediated Antibiotic Resistance and Virulence in Gram-Negatives: the Klebsiella pneumoniae Paradigm. Microbiol Spectr; 2. Epub ahead of print 3 October 2014.
DOI:10.1128/microbiolspec.plas-0016-2013.
Liu HC, Hung YP, Lin HJ, et al. Antimicrobial susceptibility of clinical Enterobacteriaceae isolates at the emergency department in a regional hospital: A threat of extended spectrum beta-lactamase-producers among nursing home residents. J Microbiol Immunol Infect. 2016;49: 584–590.
Ng TM, Khong WX, Harris PNA, et al. Empiric piperacillin-tazobactam versus carbapenems in the treatment of bacteraemia due to extended-spectrum beta-lactamase-producing Enterobacteriaceae. PLoS One; 11. Epub ahead of print 1 April 2016. DOI: 10.1371/journal.pone.0153696.
Saha AK. Pattern of Antimicrobial Susceptibility of Klebsiella Pneumoniae Isolated from Urinary Samples in urinary Tract Infection in a Tertiary Care Hospital, Kishanganj, Bihar, 5 Years’ Experience. Epub ahead of Print; 2019.
DOI: 10.21276/ijcmr.2019.6.12.42.
Najjuka CF, Kateete DP, Kajumbula HM, et al. Antimicrobial susceptibility profiles of Escherichia coli and Klebsiella pneumoniae isolated from outpatients in urban and rural districts of Uganda. BMC Res Notes. 2016;9: 1–14.
Zhang X, Zeng Q, Cai W, et al. Trends of cervical cancer at global, regional, and national level: data from the Global Burden of Disease study 2019. BMC Public Health. 2021;21:1–10.
Khairuzzaman MQ. Essential Medical Statistics. 2016;4:64–75.
Network ARS and R. Standard Operating Procedures Bacteriology; 2019.
CLSI. Clinical and Laboratory Standards Institute; 2019.
Martin RM, Cao J, Brisse S, et al. Molecular Epidemiology of Colonizing and Infecting Isolates of Klebsiella pneumoniae. mSphere; 1. Epub ahead of print October; 2016.
DOI: 10.1128/msphere.00261-16.
Gorrie CL, Mirc Eta M, Wick RR, et al. Gastrointestinal Carriage Is a Major Reservoir of Klebsiella pneumoniae Infection in Intensive Care Patients. Clin Infect Dis. 2017;65:208–215.
Adeyankinnu FA, Motayo BO, Akinduti A, et al. A multicenter study of beta-lactamase resistant escherichia coli and klebsiella pneumoniae reveals high level chromosome mediated extended spectrum β lactamase resistance in ogun state, Nigeria. Interdiscip Perspect Infect Dis; 2014. Epub Ahead of Print; 2014. DOI: 10.1155/2014/819896.
Kiratisin P, Apisarnthanarak A, Laesripa C, et al. Molecular characterization and epidemiology of extended-spectrum-β- lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates causing health care-associated infection in Thailand, where the CTX-M family is endemic. Antimicrob Agents Chemother. 2008;52:2818–2824.
Ogefere HO, Aigbiremwen PA, Omoregie R. Extended-spectrum beta-lactamase (esbl)–producing gram-negative isolates from urine and wound specimens in a tertiary health facility in southern nigeria. Trop J Pharm Res. 2015;14:1089–1094.
Akanbi BO, Ojonuba BD, Njoku R. Detection of Extended Spectrum β-Lactamase Producing Klebsiella pneumoniae and Escherichia coli in Two Hospitals in the Federal Capital Territory, Abuja, Nigeria. Open J Med Microbiol. 2013;03:207–212.
Olonitola O, Olayinka A, Inabo H, et al. Olonitola.pdf. Int J Biol Chem Sci. 2007;1:181–185.
Saraswathi R, Velayutharaj A, Noyal M. Occurrence of Extended Spectrum Beta Lactamase (ESBL) Producers in Post Operative Wound Infection. Sch J Appl Med Sci. 2015;3:995–999.
George A. Antimicrobial resistance, trade, food safety and security. One Heal. 2018;5:6–8.
Sianipar O, Asmara W, Dwiprahasto I, et al. Mortality risk of bloodstream infection caused by either Escherichia coli or Klebsiella pneumoniae producing extended-spectrum β-lactamase: A prospective cohort study. BMC Res Notes. 2019;12:1–7.
Cassini A, Högberg LD, Plachouras D, et al. Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis. Lancet Infect Dis 2019;19: 56–66.
Su X, Yan X, Li Y, et al. Identification of extended-spectrum beta-lactamase (CTX-M)-producing Klebsiella pneumoniae belonging to ST37, ST290, and ST2640 in captive giant pandas. BMC Vet Res; 18. Epub ahead of print 1 December 2022. DOI: 10.1186/S12917-022-03276-7.
Rostamian M, Kadivarian S, Kooti S, et al. Prevalence of Extended-Spectrum Beta-Lactamase in Gram Negative Bacteria Isolated from Kermanshah Medical Centers: A Systematic Review and Meta-Analysis. Iran J Med Microbiol. 2022;16: 490–505.
Mohammed Y, Gadzama GB, Zailani SB, et al. Characterization of Extended-Spectrum Beta-lactamase from Escherichia coli and Klebsiella Species from North Eastern Nigeria. J Clin Diagn Res 2016;10:DC07.
Motayo BO, Akinduti PA, Adeyakinu FA, et al. Antibiogram and plasmid profiling of carbapenemase and extended spectrum Beta-lactamase (ESBL) producing Escherichia coli and Klebsiella pneumoniae in Abeokuta, South western, Nigeria. Afr Health Sci. 2013;13:1091.
Soge OO, Queenan AM, Ojo KK, et al. CTX-M-15 extended-spectrum β-lactamase from Nigerian Klebsiella pneumoniae. J Antimicrob Chemother. 2006;57:24–30.