Emergence of Klebsiella pneumoniae strains with reduced susceptibly
against 3rd generation cephalosporins and carbapenems in Lagos
hospitals, Nigeria.
Abstract
Different samples (i.e. stool, blood, urine, sputum, wound swabs, nasal
swabs etc.) from 127 patients with suspected gram-negative infections
based on on-site performed Gram-stain from four public hospitals between
March and September 2015 in Lagos, Nigeria were analysed. Klebsiella
(K.) pneumonia was identified in 43 (34%) patients. Resistance rates of
these 43 strains according to the CLSI breakpoints were as followed:
cotrimoxazole (90.7%), cefuroxime (74.4%), ofloxacin (55.8%),
ceftazidime (46.5%), and cefixime (35%). Three isolates (7%) were
resistant to imipenem. All isolates were susceptible to
amoxicillin/clavulanic acid and nitrofurantoin. The prevalence of
ESBL-producing and carbapenem resistant strains (CRKP) was 69.8% and
7.0%, respectively. Of the ESBL producing isolates, two K. pneumoniae
isolates obtained from urine harbored both blaCTX-M-1 and blaSHV and a
third isolate from urine harbored only blaCTX-M-1. Emerging of CRKP
strains is an early warning signal for the prudent use of carbapenem
antibiotics in concern to their efficacies.