Extended-Spectrum ꞵ-Lactamases-Producing Klebsiella pneumoniae from Orthopaedic Wounds
Keyword : Orthopaedic wounds, ESBL, K. pneumoniae, Imipenem, Nigeria
Author(s) : Okwuonu, A.C And Chukwura, E.I
Abstract : This hospital-based prospective study characterized and determined the frequency of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae from orthopaedic wounds of 200 patients at an Orthopaedic hospital in south-eastern Nigerian between July 2017 and February 2018. Wound samples were collected aseptically using sterile swab sticks, and processed using standard microbiological techniques. Antibiotic susceptibility test was evaluated using Kirby-Bauer disc diffusion method while ESBL-producing K. pneumoniae isolates were confirmed using double disc synergy test (DDST). The twenty-five of the K. pneumoniae suspected ESBL producers were further tested using double disc synergy test (DDST). Molecular characterization using Polymerase Chain reaction (PCR) method was used to detect the genes encoded in the K. pneumoniae isolate. Klebsiella pneumoniae was isolated from 80 (40%) the 200 collected wound swab samples. Prevalence of infection with K. pneumoniae isolates was higher in elderly patients, with males more frequently infected than females. Also, orthopaedic leg wounds had the highest infection rate. Klebsiella pneumoniae isolates were highly resistant to the tested beta lactam antibiotics. Imipenem, a carbapenem, was the most active antibiotic against K. pneumoniae isolates. Of the twenty-five samples subjected to DDST, Ten were confirmed positive, giving a prevalence of 40.0%. Molecular characterization with PCR method also detected three genes encoded in K. pneumoniae isolate namely, Temoniera (TEM), Sulfhydryl variant (SHV) and Cefotaximase (CTX-M) genes. It is therefore imperative to curtail the continued increasing frequency of ESBL-producing K. pneumoniae in circulation through strict infection control measures and judicious use of antibiotics.