High Prevalence of Multidrug Resistant <i>Klebsiella</i> Species Isolated from the Yaounde University Teaching Hospital, Cameroon

Background and Purpose: Klebsiella species are amongst the most common causes of a variety of community-acquired and hospital-acquired infections (HAI), characterized by high morbidity and mortality rates. Most infections caused by Klebsiella species are usually treated using antibiotics. The aim of this study was to determine the antimicrobial resistance profile of Klebsiella species isolated from in-patients and out-patients at the Yaounde University Teaching Hospital. The data generated will go a long way to improve on the choice of an adequate empiric antibiotic treatment for infections caused by Klebsiella species. Methodology: A cross-sectional descriptive study was carried out over a period of 6 months, spanning from February 2019 to July 2019 with a sample size of 37 isolates, obtained from 6 different clinical specimens. Identification of isolates was done using API 20E identification system (Biomerieux SA, Lyon, France). Susceptibility to antibiotics was tested as described by Kirby-Bauer in 1956. Inhibition diameters were interpreted according to recommendations from the European Committee on Antimicrobial Susceptibility Testing (EUCAST, 2019). Results and Conclusion: Among the 37 Klebsiella isolates identified, Klebsiella pneumoniae was the most prevalent species isolated with a percentage of 54.1%, followed by Klebsiella rhinoscleromatis 18.9%, Klebsiella ozaenae 16.2% and Klebsiella oxytoca, 10.8%. The resistance pattern of Klebsiella to amoxicillin, amoxicillin/clavulanate, tircacillin, tircacillin + clavulanic acid, piperacillin, piperacillin + tazobactam, cefalotin, cefuroxim, ceftazidime, cefotaxime, ceftriaxone, cefepime, imipenem, meropenem, aztreonam, amikacin, gentamicin, tobramycin, trimethoprim/ sulfamethoxazole, nalidixic acid, pipemidic acid, norfloxacin, ciprofloxacin, levofloxacin, ofloxacin, and moxifoxacin was as follows; 100%, 86.5%, 97.3%, 83.6%, 86.5%, 16.2%, 86.5%, 83.8%, 78.4%, 32.4%, 78.4%, 76.7%, 2.7%, 2.7%, 76.7%, 13.5%, 75.7%, 73.0%, 91.9%, 51.4%, 48.6%, 64.9%, 48.6%, 48.6%, 73.0% and 62.2% respectively. Multidrug resistance was observed in 94.6% of the Klebsiella isolates. Conclusion: This study shows that the level of multidrug resistance is high. The isolates expressed good sensitivity to carbapenems, piperacillin + tazobactam, amikacin and high resistance to all other antimicrobials tested. Therefore, antimicrobial susceptibility testing prior to prescriptions should be encouraged and sensitization of the population about consequences of inappropriate antibiotic treatment and auto medication should be enforced as a means to curb antimicrobial resistance.