Detection of Multi-Drug Resistant Klebsiella Pneumoniae in Al-Zahraa University Hospital

Abstract

Background : the rate of multidrug resistant (MDR) klebsiella pneumonia is increasing worldwide, its detection by available phenotypic methods represents a challenge. However, every lab should estimate its frequency for infection control measures and antibiotic stewardship program. Objective: The aim of the study was to estimate the frequency of MDR klebsiella pneumoniae in Al-Zahraa University Hospital, Cairo, Egypt, and to determine their different phenotypic methods. Methods: frequency of MDR K. pneumoniae isolates from different clinical samples provided to the microbiology laboratory, Al-Zahraa University Hospital, Cairo, Egypt during the period from May 2016 to January 2017 was detected by different phenotypic methods including ESBL detection (ESBL combined disk test, the double disk synergy test and the ESBL NDP test), AmpC production, carbapenemase production, the temocillin disk diffusion test, the Carba NP test, the Blue carba test and the genotypic detection of OXA-48 gene). Results: out of 2058 samples provided to Al-Zahraa University Microbiology Lab, 143 isolates were K. pneumoniae (6.94 %), 120 out of these 143 (83.9 %) were MDR. Their incidence rate (0.1) from the total and (0.8) and from the K. pneumoniae isolates respectively.98.3% of these MDR were ESBL producers, 45.8% were AmpC B lactamase, 39.16% were carbapenem resistant while quinolone and aminoglycoside resistance were 63.6% and 68.3% respectively. Conclusion: continuous laboratory surveillance for different types of resistance in all K. pneumoniae isolates is recommended. ESBL NDP test and blue carba test could be used as routine tests in the microbiology lab for rapid detection of ESBL and carbapenem isolates.