OCCURRENCE OF CARBAPENEMASE AMONG KLEBSIELLA PNEUMONIAE ISOLATES FROM SELECTED HOSPITALS

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OCCURRENCE OF CARBAPENEMASE AMONG KLEBSIELLA PNEUMONIAE ISOLATES FROM SELECTED HOSPITALS

ABSTRACT

 

The spread of carbapenem-resistant bacteria has caused grave concern due to the limited choice in antibiotics for treating infections caused by Gram negative bacilli. The study was aimed to determining the prevalence of Carbapenem resistant Klebsiella pneumoniae at some hospitals in Zaria, Kaduna State. A total of 150 clinical samples comprising of urine (68), wound swab (44) and sputum (38) were collected and subjected to cultural isolation followed by biochemical identification of the isolated organisms among which 19 Klebsiella pneumoniae were identified. Antibiotic susceptibility testing was carried out on all the isolates by disc diffusion method. All the isolates were resistant to at least two of the eight different antibiotics tested. All (100%) the isolates were resistant to Ampicillin, 18 isolates (94.7%) were resistant to Cefotaxime, while 15 (78.9%) and 11 (57.9%) isolates were resistant to Cotrimoxazole and Tetracycline respectively. Low level of resistance was observed against Chloramphenicol (36.8%), Ciprofloxacin (26.3%) and Gentamicin (21.1%). The Multiple Antibiotic Resistance indices of the isolates were between 0.25 and 0.88. Out of the 19 isolates screened, only one was intermediately resistant to Imipenem. This isolate was screened for Klebsiella pneumoniae carbapenemase production using the Modified Hodge Test. The isolate was a non KPC producer, suggesting the resistance to Imipenem is likely due to other mechanism such as decreased outer membrane permeability, over expression of β-lactamases, production of cephalosporinase and porin loss. The prevalence of carbapenems resistant Klebsiella pneumoniae in Zaria as seen in this study is 5.26% and that of KPC producing Klebsiella pneumoniae is 0%. Even though the level of carbapenem resistance was low and none of the isolates was a KPC producer, most of the isolates were multidrug resistant isolates and this is alarming.

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