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Detection of Carbapenem-Resistant Klebsiella Pneumoniae Isolates from Clinical Specimens in Nnamdi Azikiwe University Teaching Hospital, Nnewi

Onukwube Cyril Chinedu; Agbakoba Nneka Regina; Egwuatu Chukwudi Charles; Aghanya Iloduba Nnaemeka.

Abstract
Background: Carbapenem-resistant Klebsiella pneumoniae is emerging rapidly worldwide. The accurate and prompt identification of Klebsiella pneumoniae carbapenemase (KPC) is a key to limiting the spread of these bacteria. Increasingly, Klebsiella bacteria have developed antibiotic resistance most recently to the class of antibiotics known as carbapenems.
Aim: The study was done to detect carbapenem-resistant Klebsiella pneumonia isolates from clinical specimens in Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.
Methodology: K. pneumoniae clinical isolates were collected and processed at Nnamdi Azikiwe University Teaching Hospital Medical Microbiology and Parasitology laboratory from August 2012 to February 2013. Fifty-two Klebsiella pneumoniae recovered from different specimens namely; wound swabs (14), urine (26), sputum (7), and endocervical swab/high vaginal swab (5) were analyzed. Antimicrobial susceptibility testing (AST) was determined by agar disc diffusion method using Mueller-Hinton agar according to Clinical and Laboratory Standards Institute recommendations. Modified Hodge test (MHT) was carried out on clinical isolates that showed reduced disc sizes to carbapenem and resistant to the third generation cephalosporin. Polymerase chain reaction (PCR) was carried out to detect the presence of blaKPC gene. Results: Antibiotics susceptibility results revealed that meropenem and Imipenem showed the highest sensitivity (100%) against the isolates tested. Ertapenem showed 94.2% sensitivity. K. pneumoniae was isolated more from female patients 30(57.7%) than from male patients 22(42.3%). The result of the single PCR also revealed the absence of blaKPC gene. The PCR and MHT results showed strong consistency when compared.
Conclusion: Care must be taken in the prescription and administration of carbapenem as it is the last resort for many bacterial infection. Infection control policies should be strictly adhered to.

Key words: K. Pneumonia;Antimicrobial susceptibility testing (AST);Parasitology;Carbapenem


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