Incidence of extended spectrum Beta-Lactamase producing Klebsiella pneumoniae among patients with urinary tract infections in Kano Metropolis Nigeria

Abstract

Extended Spectrum Beta-Lactamase (ESBLs) production is one of the ways by which bacteria become resistant to antibiotics and pathogens of UTIs such as Klebsiella pneumoniae have been incriminated at global scale. This study was conducted to investigate the incidence of Extended Spectrum Beta lactamase producing Klebsiella pneumoniae from Urinary Tract Infections in Kano metropolis. The work involved One hundred and fourty seven K. Pneumoniae isolates obtained from patients with suspected urinary tract infections were studied from January to July 2017. The identity of the isolates was confirmed using Microgen^TMGnA + B-ID System. Antibiotic susceptibility testing was carried out using the Kirby-Bauer Disc Diffusion Technique. Screening for ESBLs production was done using Clinical Laboratory Standards Institute breakpoint. Suspected ESBLs producers were subjected to confirmation using Double Disc Synergy Test. Standard Discs of Augmentin (AMC 30µG Oxoid England), Ceftazidime (CAZ 30µG, Oxoid England) and Cefotaxime (CTX 30µG, Oxoid England) were used for the screening and confirmation. Accordingly, Multidrug Resistant K. pneumoniae were found to be 63.3% and all were ESBLs producers. The Double Disc Synergy Test however confirmed 6.8% ESBLs producing K. pneumoniae. Antimicrobial sensitivity of the ESBLs producing organisms showed 100% resistance to Augmentin, ceftriaxone, ceftazidime, cefotaxime while resistance to gentamicin was 91.5%, chloramphenicol 23.4%, Nitrofurantoin 61.7%, Ciprofloxacin 93.6% and cotrimoxazole 95.7%. However, Imipenem was the most pharmacologically active drug. ESBL producing K. pneumoniae are incident in Kano and are resistant to commonly prescribed antibiotics. We, therefore, suggest screening and confirmation for ESBL in any attempt to treat UTIs due to such pathogens

Keywords: Extended Spectrum Beta Lactamases, K. pneumoniae, Urinary Tract Infection, Incidence, Kano