Antimicrobial Resistance of Klebsiella pneumoniae -ESBL Producing Strains Isolated from Clinical Specimens in Abidjan (Cote de Ivoire)

Abstract

Aims: The objective of this study is to detect the prevalence of qnr genes in broad-spectrum beta-lactamase producing Klebsiella pneumoniae, involved in hospital and community-acquired infections. Study Design: It is a retrospective study. Place and Duration of Study: Bacteriology and virology laboratorie of Institut Pasteur, Abidjan, Côte d'Ivoire. Methodology: From January 2011 to June 2016, 350 Klebsiella pneumoniae were isolated from various clinical specimens and identified by conventional bacteriological tests. Antibiotic resistance (beta-lactams, quinolones and aminoglycosides) and detection of broad-spectrum beta-lactamases were assessed by the diffusion method and the synergy test, respectively. Molecular characterization of quinolone resistance genes (qnr A, qnr B and qnr S) was performed by the conventional polymerase chain reaction (PCR). Results: Of the 350 Klebsiella pneumoniae isolates, 91(26%) were detected as ESBL producer, 36.2% (n=33) recovered from urine, 24.2% (n=22) from pus and 20.8% (n=19) from blood culture respectively. 46(33%) strains were idenifed to carry qnr genes, qnrB predominate 33(71%), followed by qnr 12(26.1%) and qnrA 1(2.2%). The strains exhibited high resistance to most of the agents tested, expect imipemen, low resistance to amikacin 4.1%, moderate to cefoxitin 31.8% and 54.9% with amoxicillin-clauvanic acid. Conclusion: Although these observed prevalences are small proportions, this can be seen as a warning signal for the future. The emergence and dissemination of resistance genes in Côte d'Ivoire could pose a public health problem. Thus, the establishment of a relevant resistance surveillance policy to better control the circulation of multidrug-resistant strains is necessary.