Eloise Müller-Schulte1, Marie Nonfra Tuo2, Chantal Akoua-Koffi2, Frieder Schaumburg3, Sören L Becker4. 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.
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 illpatients with suspected Gram-negative infections, and the establishment of antimicrobial resistance surveillance systems.
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