Antimicrobial resistance profiles of Klebsiella Pneumoniae at Clinical Microbiology Laboratory of Makerere College of Health Sciences
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Date
2024Author
Okwerede, John
Kaija, Pius
Nakawungu, Phildauce
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Background: Klebsiella pneumoniae is a frequent nosocomial pathogen. It has also emerged as an agent of severe community-acquired infections, including pyogenic liver abscess, pneumonia, and meningitis. The beta-lactam antibiotics, in combination with aminoglycosides, are among the most widely prescribed antibiotics and are important components in empirical therapy. However, reports of multidrug resistant K. pneumoniae is a major public health concern The aim of this study was to determine the antimicrobial resistance (AMR) profile of K. pneumoniae isolates recovered from the Clinical Microbiology Laboratory of Makerere University, College Health Sciences in the period of January to December 2023. Objectives: The objectives of this study were to determine antimicrobial resistance profile, the phenotypes of antimicrobial resistance and to demonstrate antimicrobial resistant gene transferability of Klebsiella pneumoniae isolates at the Clinical Microbiology Laboratory. Methods: A laboratory-based cross-sectional study was conducted from April 2024 to June 2024 at Clinical Microbiology at the College of health sciences; Makerere University located on Mulago Hill, Kampala. The archived isolates of K. pneumoniae were re-identified by cultural and biochemical methods and antibiotic sensitivity test (AST) performed according to Kirby Bauer disk diffusion methods on Mueller-Hinton agar. Extended spectrum beta-lactamase (ESBL) production in Klebsiella pneumoniae was tested by double-disc synergy test and antibiotic resistant gene transferability demonstration done by carrying out a conjugation experiment and the trans conjugant subjected to AST tests using similar antibiotics as those used for the donor to determine co-resistance. Results: The re-identification tests of the archived isolates confirmed 22 isolates to be K. pneumoniae out of the 23 received. The isolates showed resistances to the antibiotics as follows; Ampicillin (100%), Cefuroxime (100%), Ceftriaxone (100%), Cotrimoxazole (95.5%), Ceftazidime (95.5%), Cefotaxime (90.9%) and Gentamycin (72.7%). Moderate resistance was seen in Nitrofurantoin (59.1%) and Amoxiclav (54.1%). The least resistance was seen in Imipenem (4.5%). The conjugation experiment demonstrated a successful transfer of resistance against ceftriaxone from 05KP isolate to J53 strain of E. coli. The 05T demonstrated co-resistance against lower class beta-lactams like Ampicillin, Cefuroxime, Ceftazidime and Cefotaxime. Conclusion: These findings suggest a high resistance of K. pneumoniae to commonly used antibiotics and therefore there is a need to opt for AST guided management of patients and to continually do surveillance on AMR. The study further confirms evidence of transfer of resistance from one organism to another. There is therefore need for improvement of IPC practices in healthcare settings.