Evolution of the Resistance Profile of Klebsiella Species to Antibiotics Over Ten Years at the Yaoundé University Teaching Hospital, Cameroon

Abstract

Aims: This study aimed to study the resistance profile of Klebsiella species to antibiotics, highlighting their resistance phenotypes at the Yaoundé University Teaching Hospital (YUTH). Study Design:  We carried out a retrospective and prospective study. Place and Duration of Study: Bacteriology unit, Yaoundé University Teaching Hospital, from January 2010 to December 2020. Methodology: Antibiotic susceptibility testing (AST) was performed using the Kirby-Bauer disc diffusions method on Muller Hinton agar according to the AST committee of the French Society of Microbiology (CASFM, 2020). The data was digitized and analyzed using descriptive statistics to understand the antibiotic resistance patterns of Klebsiella species. Results: During this study, we identified 589 strains of Klebsiella species. Klebsiella pneumoniae pneumoniae was the most frequent sub-specie identified (64.69%). Blood and urine specimens were the samples that were frequently encountered. Children under 10 and adults over 60 were the most infected groups of patients. The majority of the samples analysed came respectively from the Intensive Care Units (21.22%), Paediatrics (14.60%), and Medicine (12.56%). The Klebsiella species isolated showed a high resistance rate to beta-lactams (72%), phenolics (62.30%), and quinolones (60.41%). Over the years, we have observed a gradual decline in the resistance rate to aminoglycosides, going from 87.80% in 2010 to 11.11% in 2020 with amikacin, which remains the most active. Resistance to colistin, which is one of the last therapeutic resort antibiotics, showed very alarming resistance rates of 63.63% with low rates in 2016 (0%) and 25% in 2018. Klebsiella species retained good sensitivity to the piperacillin-tazobactam, as well as to imipenem and nitrofurantoin with low resistance rates for these last two antibiotics (8.33% and 15% respectively). Conclusion: Based on our findings, which indicate a significant level of resistance among Klebsiella species to commonly prescribe antibiotics, it is crucial for both the health authorities in Cameroon and specifically at the YUTH to take prompt actions.