TITLE:
High Prevalence of Multidrug Resistant Klebsiella Species Isolated from the Yaounde University Teaching Hospital, Cameroon
AUTHORS:
Emilia Enjema Lyonga Mbamyah, Florence Anjabie Enyeji, Judith Torimiro, Patience Mangum, Modestine Djuissi, Aime-Caesar Teukam, Martha Tongo Mesembe, George Mondinde Ikomey, Anicette Chafa Betbeui, Dieudonné Sedena, William Baiye, Agnes Bedie Eyoh, Hortense Kamga Gonsu
KEYWORDS:
Klebsiella Species, Antimicrobial Resistance, Multidrug Resistance
JOURNAL NAME:
Open Journal of Medical Microbiology,
Vol.11 No.2,
June
4,
2021
ABSTRACT: Background and Purpose: Klebsiella species are amongst the most common causes of a variety of
community-acquired and hospital-acquired infections (HAI), characterized by
high morbidity and mortality rates. Most infections caused by Klebsiella species are usually treated
using antibiotics. The aim of this study was to determine the antimicrobial
resistance profile of Klebsiella species isolated from in-patients and out-patients at the Yaounde University
Teaching Hospital. The data generated will go a long way to improve on the
choice of an adequate empiric antibiotic treatment for infections caused by Klebsiella species. Methodology: A
cross-sectional
descriptive study was carried out over a period of 6 months, spanning from
February 2019 to July 2019 with a sample size of 37 isolates, obtained from 6
different clinical specimens. Identification of isolates was done using API 20E
identification system (Biomerieux SA, Lyon,
France). Susceptibility to antibiotics was tested as described by
Kirby-Bauer in 1956. Inhibition diameters were interpreted according to
recommendations from the European Committee on Antimicrobial Susceptibility Testing (EUCAST, 2019). Results and Conclusion: Among the 37 Klebsiella isolates identified, Klebsiella
pneumoniae was the most prevalent species isolated with a percentage of
54.1%, followed by Klebsiella rhinoscleromatis 18.9%, Klebsiella ozaenae 16.2% and Klebsiella oxytoca, 10.8%. The
resistance pattern of Klebsiella to
amoxicillin, amoxicillin/clavulanate, tircacillin, tircacillin + clavulanic
acid, piperacillin, piperacillin + tazobactam, cefalotin, cefuroxim,
ceftazidime, cefotaxime, ceftriaxone, cefepime, imipenem, meropenem, aztreonam,
amikacin, gentamicin, tobramycin, trimethoprim/ sulfamethoxazole, nalidixic acid, pipemidic acid,
norfloxacin, ciprofloxacin, levofloxacin, ofloxacin, and moxifoxacin was as
follows; 100%, 86.5%, 97.3%, 83.6%, 86.5%, 16.2%, 86.5%, 83.8%, 78.4%, 32.4%,
78.4%, 76.7%, 2.7%, 2.7%, 76.7%, 13.5%, 75.7%, 73.0%,
91.9%, 51.4%, 48.6%, 64.9%, 48.6%, 48.6%, 73.0% and 62.2%
respectively. Multidrug resistance was observed in 94.6% of the Klebsiella isolates. Conclusion: This
study shows that the level of multidrug resistance is high. The isolates
expressed good sensitivity to carbapenems, piperacillin + tazobactam, amikacin
and high resistance to all other antimicrobials tested. Therefore,
antimicrobial susceptibility testing prior
to prescriptions should be encouraged and sensitization of the population about
consequences of inappropriate antibiotic treatment and auto medication should
be enforced as a means to curb antimicrobial resistance.