Resistance of Clinical Isolates of Escherichia coli and Klebsiella pneumoniae in “Boucle du Mouhoun, Burkina Faso”: one year's Experience in Antibiotic Resistance Surveillance

Abstract

Introduction: Escherichia coli and Klebsiella pneumoniae account for a large proportion of clinically isolated pathogenic bacteria. However, their resistance to antibiotics is increasingly becoming a global health threat. The aim of this study was to describe the current antibiotic resistance profile of these two species. Materials and method: This was a retrospective descriptive study at the Dedougou regional hospital. The results of antibiotics susceptibility testing of non-redundant clinical isolates of Enterobacteriaceae were used. Bacteria were isolated and identified using standard bacteriology methods. The antibiogram was performed by the Kirby-Bauer method and the interpretation was made according to the recommendations of the Antibiogram Committee of the French Microbiology Society (CASFM 2017). Data were entered into WHOnet 2018 and analysed using EPI-INFO 7.2.4.0. Results: A total of 138 non-redundant Enterobacteriaceae strains were isolated, of which almost 90% were E. coli (75.4%) and Klebsiella pneumoniae (13.8%). The most frequent resistance was observed with amoxicillin + clavulanic acid (81.3%), ceftriaxone (66.7%) and cotrimoxazole (82.9%). E. coli showed very high resistance to ampicillin (95.2%). Relatively moderate to high resistance was also observed with ciprofloxacin 69.1% and gentamicin 39%. The most active antibiotics were imipenem and cefoxitin, with resistance frequencies of 2.4% and 5.7% of all strains respectively. ESBL-producing strains were the most frequently encountered phenotypes (59.3%), followed by high-level penicillinases (19.5%). 3GC resistance was associated to ESBL production in almost 90% of cases, and both ciprofloxacin and gentamicin resistance were significantly associated with 3GC resistance (p<0.001). Conclusion: Escherichia coli and Klebsiella pneumoniae are the main enterobacteria isolated in clinics. The production of extended-spectrum beta-lactamases is their main mechanism of resistance to beta-lactam antibiotics.