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Int J Infect Dis. 2019 Nov 23;91:207-209. doi: 10.1016/j.ijid.2019.11.024. [Epub ahead of print]

High prevalence of ESBL-producing Klebsiella pneumoniae in clinical samples from central Côte d'Ivoire.

Author information

1
Diagenos, Healthcare Center for Human Genetics, Osnabrück, Germany; Center for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg/Saar, Germany; Institute of Medical Microbiology, University Hospital Münster, Münster, Germany. Electronic address: eloise.mueller-schulte@diagenos.com.
2
Laboratoire de Bactériologie-Virologie, Centre Hospitalier Universitaire de Bouaké, Bouaké, Côte d'Ivoire; Unité de Formation et Recherche Sciences Médicales, Université Alassane Ouattara de Bouaké, Bouaké, Côte d'Ivoire.
3
Institute of Medical Microbiology, University Hospital Münster, Münster, Germany.
4
Center for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg/Saar, Germany; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland. Electronic address: soeren.becker@uks.eu.

Abstract

OBJECTIVES:

Infections caused by multidrug-resistant Enterobacterales pose a significant challenge to clinical patient care, particularly in resource-constrained settings where epidemiological data on antimicrobial resistance are scarce. The aim of this study was to determine the prevalence of extended spectrum beta-lactamase-(ESBL)-producing Klebsiella pneumoniae among clinical samples from a teaching hospital in Bouaké, central Côte d'Ivoire.

METHODS:

Clinical specimens were collected from sterile and non-sterile body sites and were subjected to microbiological diagnostics (April 2016-June 2017). The antimicrobial susceptibility patterns of K. pneumoniae were analysed using automated resistance testing and double-disk diffusion to test for ESBL production. Multiplex PCR was carried out to determine the presence of the resistance-conferring genes blaCTX-M, blaSHV and blaTEM.

RESULTS:

A total of 107 isolates were included, most of which were obtained from bloodstream (39%; n=42) and urinary tract infections (39%; n=42). Among all K. pneumoniae isolates, 84% (n=90) were ESBL producers, many of which were also not susceptible to sulfonamides (99%), quinolones (81%) and aminoglycosides (79%). The majority of ESBL-producing strains harboured all three investigated bla genes.

CONCLUSION:

The high prevalence of ESBL-producing K. pneumoniae in clinical isolates from Côte d'Ivoire calls for revised empirical treatment regimens in critically ill patients with suspected Gram-negative infections, and the establishment of antimicrobial resistance surveillance systems.

KEYWORDS:

Africa; Antibiotics; Antimicrobial resistance; Bacteria; Diagnosis; Enterobacterales; Sepsis

PMID:
31770618
DOI:
10.1016/j.ijid.2019.11.024
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