Emergence of Klebsiella pneumoniae strains with reduced susceptibly against 3rd generation cephalosporins and carbapenems in Lagos hospitals, Nigeria  : [Preprint]

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, twoK. pneumoniae isolates obtained from urine harbored bothbla CTX-M-1 and bla SHV and a third isolate from urine harbored only bla CTX-M-1. Emerging of CRKP strains is an early warning signal for the prudent use of carbapenem antibiotics in concern to their efficacies.