The Emergence of Klebsiella pneumoniae with Reduced Susceptibility Against Third Generation Cephalosporins and Carbapenems in Lagos Hospitals, Nigeria

Akinyemi, Kabiru O.; Abegunrin, Rebecca O.; Iwalokun, Bamidele A.; Fakorede, Christopher O.; Makarewicz, Oliwia; Neubauer, Heinrich Karl Johann GND; Pletz, Mathias W.; Wareth, Gamal GND

This study investigated the prevalence of Klebsiella (K.) pneumoniae isolates among clinical samples of patients in four medical centers in Lagos, Nigeria and the burden of extended-spectrum beta-lactamases (ESBL) and carbapenem-resistant K. pneumoniae (CRKP) strains. Different samples (stool, blood, urine, wound swabs and nasal swabs) from 127 patients with suspected Gram-negative infections based on on-site performed Gram-stain from four public hospitals between March and September 2015 were analyzed. K. pneumoniae 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, MDR and CRKP strains was 69.8%, 62.8%, and 7.0%, respectively. Of the ESBL-producing isolates, two K. pneumoniae isolates obtained from urine harbored both blaSHV and blaCTX-M-1, and a third isolate from urine harbored only the blaCTX-M-1. This study revealed the emergence of CRKP isolates and blaCTX-M-1 and blaSHV co-harboring K. pneumoniae strains in Lagos hospitals. The emergence of CRKP strains is an early warning signal for carbapenem antibiotics’ prudent use with concern for their efficacies.

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Akinyemi, Kabiru / Abegunrin, Rebecca / Iwalokun, Bamidele / et al: The Emergence of Klebsiella pneumoniae with Reduced Susceptibility Against Third Generation Cephalosporins and Carbapenems in Lagos Hospitals, Nigeria. 2021.

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