*[1],3Ukam, I. I., 3Umoh, N. O., 1Iyam, S. O., 2Nwibari, B. M. W., 1Ugwu, J. C., 3Ben, S. A., and 3Ogba, O. M.
1Department of Microbiology, Faculty of Biological Sciences, University of Calabar, PMB 1115 Calabar, Nigeria
2Department of Zoology and Environmental Biology, Faculty of Biological Sciences, University of Calabar, PMB 1115 Calabar, Nigeria
3Department of Bacteriology, Virology and Mycology, Faculty of Medical Laboratory Science, University of Calabar, PMB 1115, Calabar, Nigeria
*Correspondence to: ukamjohn8@gmail.com; igborukam@unical.edu.ng; Tel: +2349074254995/ +2348032327041; ORCiD: 0009-0005-7645-5508
Abstract:
Background: The global spread of extended spectrum beta-lactamases (ESBL) and carbapenemase-producing strains of Klebsiella pneumoniae, is considered a major public health threat to humans. Antimicrobial resistance mediated by New Delhi Metallo-β-lactamase (NDM) enzyme has become a major threat to treatment outcome. This study is aimed at investigating the carriage rate of blaNDM gene among multidrug resistant (MDR) clinical K. pneumoniae isolates from four selected health facilities in Calabar, Nigeria.
Methodology: This was a laboratory-based study of 70 confirmed K. pneumoniae isolates recovered from various clinical sources at the University of Calabar Teaching Hospital (UCTH), General Hospital Calabar (GHC), Faith Foundation Specialist Clinic (FFSC) and Bakor Medical Centre Calabar (BMCC) using the Vitek® 2 Compact system, with antibiotic susceptibility testing performed by the Kirby-Bauer disc diffusion method. Molecular detection of blaNDM gene in 15 selected MDR isolates was carried out by conventional PCR assay and agarose gel electrophoresis detection of the gene amplicon.
Results: The distribution of the confirmed isolates according to healthcare facilities showed that the highest frequency of K. pneumoniae isolates was obtained from UCTH (52.9%, n=37), followed by GHC (17.1%, n=12), BMCC (15.7%, n=11) and FFSC (14.3%, n=10). Urine sample accounted for the highest frequency of the isolates (40.0%, n=28), followed by sputum (31.4%, n=22), wound swabs (8.6%, n=6), and blood (5.7%, n=4) while the frequency of isolates was higher among inpatients (57.1%, n=40) than outpatients (42.9%, n=30). The susceptibility of the isolates to meropenem, ertapenem, piperacillin/tazobactam, amoxicillin/clavulanate, ciprofloxacin, gentamicin and ceftazidime was 57.1% (n=40), 54.3% (n=38), 51.4% (n=36), 50.0% (n=35), 48.6% (n=34), 47.1% (n=33) and 17.1% (n=12) respectively. Eighteen (25.7%) isolates were MDR K. pneumoniae strains while blaNDM gene was detected in 9 (60.0%) of 15 MDR isolates tested.
Conclusion: The high prevalence of the resistance gene in this study setting underscores the urgent need for an informed and discrete use of antimicrobial drugs, particularly β-lactam antibiotics, for management of bacterial infections to prevent further spread of drug-resistant K. pneumoniae strains.
Keywords: Klebsiella pneumoniae, Multidrug Resistance, Multiple antibiotic resistance index, NDM gene
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