Detection of Antimicrobial Susceptibility Pattern and Molecular Detection of Resistance Genes in Klebsiella pneumoniae Isolated from Urine Samples of Suspected UTI Patients Attending Public Hospitals in Nasarawa South Senatorial District, Nasarawa State, Nigeria

Abstract

Aims: The aim of the current study was to determine antimicrobial susceptibility patterns and the incidence of resistance genes (β-lactamase-encoded genes) among clinical isolates of K. pneumoniae.
 Study Design: Investigative.
 Place and Duration of Study: Department of Microbiology, Nasarawa State University, Keffi, between November 2022 and July 2023.
 Methodology: A total of 375 clinical samples were randomly collected from patients and isolation and identification was done using standard microbiological methods. The antibiotic susceptibility testing for the isolates was carried out in accordance with the Clinical and Laboratory Standards Institute protocol. The detection of extended-spectrum beta-lactamase (ESBL) production in K. pneumoniae isolates was carried out using double disc synergy test. In addition, molecular detection of ESBL genes was carried out using Polymerase Chain Reaction (PCR) method.
 Results: The overall incidence rate of K. pneumoniae in the 375 clinical samples from Nasarawa South Senatorial District was 38 (10.13%). Resistance was high to ampicillin (94.74%) and amoxicillin-clavulanic acid (73.6%) but low to cefotaxime (13.16%), ceftriaxone (18.42%), ceftazidime and cefoxitin (23.60%) and gentamicin (28.94%). Most of the isolates were multi-drug resistant (MDR; 81.5%) and none was Pan Drug resistant. All 15 isolates jointly resistant to cefotaxime and/or ceftazidime and ciprofloxacin 100.0% were ESBL producers, distributed as follows: blaCTX-M-1 7(46.6%); blaCTX-M-34(26.6%); blaSHV 6(40.0%); blaTEM6 (40.0%); and blaOXA 5(33.3%).
 Conclusion: K. pneumoniae isolated from the urine of patients attending public hospitals in Nasarawa South were less resistant to cefotaxime, ceftazidime, gentamicin, ceftriaxone, and cefoxitin in the study location. This implies that the antibiotics are useful in the treatment of infection caused by K. pneumoniae. Also, ESBL-positive K. pneumoniae isolates harbored ESBL genes, with blaCTX-M as the most common.