Abstract
Klebsiella pneumoniae is an opportunistic pathogen of medical importance and the capsule and mucoid phenotype in this organism are considered as requisite virulence determinants. A total of 62 clinical samples from ATBUTH were collected and screened for K. pneumoniae. The isolates were identified using standard tests for this organism. The string test was used to detect the mucoid (hypermucoviscous) phenotype and the antimicrobial susceptibility test to 10 antibiotics was carried out with the disk diffusion technique after standardizing inoculum. A K. pneumoniae prevalence of 24% (15/62) was obtained of which 47% (7/15) were mucoid (hypermucoviscous) and 53% (8/15) were non-mucoid. Colonial sizes of the two strains do not reveal any significant differences in growth fitness of the strains. On blood agar, the mucoid and non-mucoid strains had a mean colonial size ± standard deviations of 4.41 ± 0.58 mm and 4.27 ± 0.42 mm respectively. The antibiotic susceptibility rate showed that the mucoid strains compared to the non-mucoid were more resistant to nine out of 10 antibiotics. The mucoid strains were outrightly resistant to augmentin, amoxicillin, septrin, sparfloxacin and perfloxacin. The non-mucoid strains showed no complete resistant to any antibiotic tested but had a higher resistant rate to chloramphenicol only. The Multiple Antibiotic Resistance (MAR) index shows the themucoid strains with a high MAR index range of 0.7 - 1.0 with a median MAR index of 0.8, while the non-mucoid strains had a MAR index of 0.2 - 0.8 with a median MAR index of 0.35. The data suggest that the mucoid phenotype could be associated with extrachromsomal element(s) carrying resistance genes to antibiotics and that these extrachromosomal elements may not harbour resistance determinants to chloramphenicol. Furthermore, the extrachromosomal elements bearing the mucoid phenotype and the resistance elements in the mucoid strains do not significantly impact on the fitness of the cognate strain. Whether these phenotype and resistances that had no fitness cost to the bacterium could significantly affect the virulence of the bacteria in vivo remains to be investigated.
Highlights
Klebsiella pneumoniae is a gram negative bacteria and an opportunistic pathogen
The mucoid strains were completely resistant to five antimicrobials namely amoxicillin, augmentin (β-Lactams), sparfloxacin, perfloxacin and septrin, they were resistant to azithromycin (86%), streptomycin (86%), ciprofloxacin (86%) and gentamicin (71%)
Resistance to single antibiotic was not found among the strains, though 10 antibiotics were tested, the antibiotics belong to six classes of antimicrobials; β-Lactams (2), sulphonamide (1), aminoglycosides (3), chloramphenicol (1) and quinolones (3)
Summary
Klebsiella pneumoniae is a gram negative bacteria and an opportunistic pathogen. In humans K. pneumoniae is an important species of medical importance of the genus Klebsiella and is found as saprophyte in the nasopharynx and in the gastrointestinal tract. K. pneumoniae causes suppurative infections, bacteremia and septicaemia. The bacteria accounts for a great majority of hospital associated infections in neonates, immunocompromised patients, patients undergoing respiratory therapies and patients hospitalized in urology and burn wards. Example of serious community associated infections due to K. pneumoniae is Friedlander’s pneumonia, a severe form of lobar pneumonia with high mortality, and in some countries the organism is the leading cause of pneumonia. K. pneumoniae invasive community acquired pyogenic liver abscess (PLA) sometimes complicated by endophthalmitis or meningitis emerged in Taiwan and other Asian countries as well as other continents [1]
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