Abstract
To assess the prevalence of ESBL producing and carbapenem resistant Klebsiella pneumoniae isolated from in-come and out-come patients at Sahloul-university hospital. A retrospective study over a 3 years period (January 2012 and December 2014) focused on 2160 strains of Klebsiella pneumoniae. Statistical analysis was carried out using SPSS program. ESBL detection was performed using a double disc diffusion method and carbapenemase detection was realized by Rosco-Disk kit. A total of 2160 Klebsiella pneumoniae strains were isolated during the period of the study, 26.2% (n=566) were ESBL-producers and 15.8% (n=342) showed resistance to carbapenem. The wards most affected by these strains were basically urology and intensive care units. Eighty four percent of studied strains (203/241) were resistant to temocillin, which correlate with the production of a class D (OXA-48-like) carbapenemase and 7% (17/241) showed sensitivity to EDTA and dipicolinic acid, which indicate the production of metallo-enzyme. The rate of resistance to colistin remains low. Resistance of Enterobacteriaceae, including K. pneumoniae, to third generation cephalosporins (3rd GC) and carbapenem through the mechanism of ESBL and carbapenemases production is becoming increasingly worrying. This suggests a more rational use of antibiotics, as well as the rigorous application of hygiene measurement.
Highlights
Hospital infections have become a growing healthcare challenge in recent decades and serious concerns haveIn view of emergence of ESBL and AmpC-producing bacteria, carbapenems are the β-lactam group of drugs that are often used as antibiotics of last resort and have shown their stability for treating infection due to multidrug-resistant bacteria[1]
Despite the recommendations concerning the rational use of antibiotics and the strengthening of hygiene procedures to limit the emergence of multidrug resistant bacteria, the number of epidemics due to carbapenemase-producing bacteria has been increasing in several countries throughout the world
The aim of this study was to describe the general state of the evolution of resistance in Enterobacteriaceae and especially in Klebsiella pneumoniae isolated in the laboratory of microbiology in Sahloul hospital and to phenotypically elucidate the mechanisms responsible for resistance to the molecules of carbapenems
Summary
Emergent Bacterial Resistance and Safety of Care (UR12SP37), Laboratory of Microbiology, University Hospital Sahloul, Sousse, Tunisia. 2. Laboratory of Metabolic Biophysics and Applied Pharmacology (LR12ES02), Department of Biophysics, Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Sousse, Tunisia. 3. Faculty of Medicine Ibn Al Jazzar, Sousse, University of Sousse, Tunisia. 4. Faculty of Pharmacy, Monastir, University of Monastir, Monastir, Tunisia
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