Survey for Carbapenem Resistant Klebsiella Pneumoniae among Patients Attending Aminu Kano Teaching Hospital, Kano, Nigeria

Abstract

Carbapenem resistant Klebsiella pneumoniae is becoming a more significant pathogen because of the grave clinical risk it poses which affects patient’s treatment outcome. This study aimed to survey for carbapenem resistant Klebsiella pneumoniae (CRKP) among patients attending Aminu  Kano Teaching Hospital, Kano State, Nigeria. A total of 600 clinical samples including urine, sputum and swabs were collected and screened. Klebsiella pneumoniae were isolated and confirmed using culture, microscopy and biochemical test according to standard microbiological techniques. Phenotypic carbapenem resistant and carbapenemase production were detected using meropenem discs diffusion method and modified Hodge test respectively. Genotypic carbapenemase productions were confirmed by detecting the presence of blaKPC genes using PCR and Gel electrophoresis. Antibiotics susceptibility profiles of the CRKP isolates were evaluated using disc diffusion method and interpreted using CLSI protocols. The study revealed the incidence of Klebsiella pneumoniae infection as 14% with the highest occurrence in sputum (18%) and the lowest in swab (10%). Of the total number of isolated K. pneumoniae, 14.3% were found to be carbapenem resistant. Up to 75% of CRKP isolates were found to produce carbapenamase and harbor blaKPC genes. Antibiotic susceptibility profile of these isolates revealed colistin and tigecycline as the most active antibiotics in vitro (92%).The isolates were found to be generally resistant  to cefepime, ceftriaxone, cefuroxime, cotrimoxazole and ciproflaxin (100%). Up to 8% of the isolates were sensitive to Gentamicin and Nalidixic acid, 25% to Nitrofurantoin, 50% to Minocycline and 17% to Amikacin. This study verifies the existence of carbapenem resistant Klebsiella pneumoniae isolates that are highly resistant to other antibiotics in patients attending AKTH Kano which is an indication of increase in drug resistance. This requires the need for newer tactics in infection control to prevent the spread of carbapenem resistant isolates.