Klebsiella pneumoniae Antibiotic Resistance Pattern Towards Antimicrobial Agents in Urinary Tract Infection Patients in Zawia City / Libya

Authors

  • Ghada Abougrara Department of General and Basic Sciences, Faculty of Dentistry, University of Zawia, Zawia, Libya. Author
  • Ali alkhboli Department of General and Basic Sciences, Faculty of Dentistry, University of Zawia, Zawia, Libya. Author
  • Fatma twair 3 department of Oral Medicine, Faculty of Dentistry, University of Zawia, Zawia, Libya Author
  • Subhia Shaglabow Department of General and Basic Sciences, Faculty of Dentistry, University of Zawia, Zawia, Libya Author

DOI:

https://doi.org/10.54361/LJM18-06

Keywords:

Urinary tract infections (UTIs), pneumonia, Antibiotic resistance, Meropenem, Tetracycline,, Zawia

Abstract

Urinary Tract Infections (UTIs) represent a significant public health concern, contributing to serious health issues, extensive antibiotic use globally, and ranking as the second most common reason for clinical consultations in community settings. Various bacteria, particularly from the Enterobacteriaceae family, including Klebsiella spp., are implicated in the etiology of UTIs. This study focused on assessing the prevalence and antibiotic resistance patterns of uropathogenic K. pneumoniae across different age groups and genders. A total of 819 urine samples were collected from patients visiting Zawia hospitals and clinics between September 2022 and February 2023. Identification of K. pneumoniae was performed through colony morphology, Gram staining, and biochemical assays, followed by antibiotic susceptibility testing. Out of all samples, 271 (33.07%) exhibited significant bacterial growth. The incidence of UTIs was notably higher in females (40.15%) compared to males (20.6%). The age group of 1-9 years showed the highest susceptibility to UTIs at 35.4%. K. pneumoniae accounted for 23.9% of all UTI cases, with a higher prevalence in males (31.14%) than in females (21.9%). The 1-9 year age group was identified as the most vulnerable to K. pneumoniae infections, with a prevalence of 29.2%. K. pneumoniae demonstrated a high susceptibility rate of 86.2% to Meropenem, while showing significant resistance to Tetracycline at 70.8%. The findings indicate a high prevalence of UTIs in the 1-9 year age group, with females at greater risk. Males exhibited a higher susceptibility to K. pneumoniae, particularly in the younger age group. The bacterium showed strong sensitivity to Meropenem and considerable resistance to Tetracycline. Increased awareness and regular monitoring of antimicrobial usage in healthcare settings are essential to mitigate resistance rates and combat this pathogen.

References

Al-Naqshbandi, A. A., Chawsheen, M. A., & Abdulqader, H. H. (2019). Prevalence and antimicrobial susceptibility of bacterial pathogens isolated from urine specimens received in rizgary hospital - Erbil. Journal of infection and public health, 12(3), 330–336. https://doi.org/10.1016/j.jiph.2018.11.005 DOI: https://doi.org/10.1016/j.jiph.2018.11.005

Gonzalez, C. M., & Schaeffer, A. J. (1999). Treatment of urinary tract infection: what's old, what's new, and what works. World journal of urology, 17(6), 372–382. https://doi.org/10.1007/s003450050163. DOI: https://doi.org/10.1007/s003450050163

Podschun, R., & Ullmann, U. (1998). Klebsiella spp. as nosocomial pathogens: epidemiology, taxonomy, typing methods, and pathogenicity factors. Clinical microbiology reviews, 11(4), 589–603. https://doi.org/10.1128/CMR.11.4.589 DOI: https://doi.org/10.1128/CMR.11.4.589

Ciobotaro, P., Oved, M., Nadir, E., Bardenstein, R., & Zimhony, O. (2011). An effective intervention to limit the spread of an epidemic carbapenem-resistant Klebsiella pneumoniae strain in an acute care setting: from theory to practice. American journal of infection control, 39(8), 671–677. https://doi.org/10.1016/j.ajic.2011.05.004. DOI: https://doi.org/10.1016/j.ajic.2011.05.004

Gajdács, M., Bátori, Z., Ábrók, M., Lázár, A., & Burián, K. (2020). Characterization of Resistance in Gram-Negative Urinary Isolates Using Existing and Novel Indicators of Clinical Relevance: A 10-Year Data Analysis. Life (Basel, Switzerland), 10(2), 16. https://doi.org/10.3390/life10020016. DOI: https://doi.org/10.3390/life10020016

Azadpour, M., Nowroozi, J., Goudarzi, G. R., & Mahmoudvand, H. (2015). Presence of qacEΔ1 and cepA genes and susceptibility to a hospital biocide in clinical isolates of Klebsiella pneumoniae in Iran. Tropical biomedicine, 32(1), 109–115.

Bengoechea, J. A., & Sa Pessoa, J. (2019). Klebsiella pneumoniae infection biology: living to counteract host defences. FEMS microbiology reviews, 43(2), 123-144. DOI: https://doi.org/10.1093/femsre/fuy043

Thakur, S., Pokhrel, N., & Sharma, M. (2013). Prevalence of multidrug resistant Enterobacteriaceae and extended spectrum β lactamase producing Escherichia Coli in urinary tract infection. Res J Pharm Biol Chem Sci, 4(2), 1615.

Farajnia, S., Alikhani, M. Y., Ghotaslou, R., Naghili, B., & Nakhlband, A. (2009). Causative agents and antimicrobial susceptibilities of urinary tract infections in the northwest of Iran. International journal of infectious diseases, 13(2), 140-144. DOI: https://doi.org/10.1016/j.ijid.2008.04.014

Storme, O., Tirán Saucedo, J., Garcia-Mora, A., Dehesa-Dávila, M., & Naber, K. G. (2019). Risk factors and predisposing conditions for urinary tract infection. Therapeutic advances in urology, 11, 1756287218814382. DOI: https://doi.org/10.1177/1756287218814382

Caron, F. (2009). Diagnosis and treatment of community-acquired urinary tract infections in adults: what has changed. Comments on the 2008 guidelines of the French Health Products Safety Agency (AFSSAPS). Presse Medicale (Paris, France: 1983), 39(1), 42-48.

Gajdács, M., & Albericio, F. (2019). Antibiotic Resistance: From the Bench to Patients. Antibiotics (Basel, Switzerland), 8(3), 129. https://doi.org/10.3390/antibiotics8030129 DOI: https://doi.org/10.3390/antibiotics8030129

De Francesco, M. A., Ravizzola, G., Peroni, L., Negrini, R., & Manca, N. (2007). Urinary tract infections in Brescia, Italy: etiology of uropathogens and antimicrobial resistance of common uropathogens. Medical science monitor : international medical journal of experimental and clinical research, 13(6), BR136–BR144.

Dias Neto, J. A., Martins, A. C. P., Silva, L. D. M. D., Tiraboschi, R. B., Domingos, A. L. A., Cologna, A. J., ... & Tucci Jr, S. (2003). Community acquired urinary tract infection: etiology and bacterial susceptibility. Acta Cirurgica Brasileira, 18, 33-36. DOI: https://doi.org/10.1590/S0102-86502003001200012

Mansour, A., MAHDINEZHAD, M., & Pourdangchi, Z. (2009). Study of bacteria isolated from urinary tract infections and determination of their susceptibility to antibiotics.

Wilson ML, Gaido L. Laboratory diagnosis of urinary tract infections in adult patients. Clin Infect Dis. 2004;38(8):1150-1158. doi:10.1086/383029 DOI: https://doi.org/10.1086/383029

Wayne, P. A. (2010). Clinical and Laboratory Standards Institute: Performance standards for antimicrobial susceptibility testing: 20th informational supplement. CLSI document M100-S20.

Assafi, M. S., Ibrahim, N. M., Hussein, N. R., Taha, A. A., & Balatay, A. A. (2015). Urinary bacterial profile and antibiotic susceptibility pattern among patients with urinary tract infection in duhok city, kurdistan region, Iraq. International Journal of Pure and Applied Sciences and Technology, 30(2), 54.

Dason, S., Dason, J. T., & Kapoor, A. (2011). Guidelines for the diagnosis and management of recurrent urinary tract infection in women. Canadian Urological Association Journal, 5(5), 316. DOI: https://doi.org/10.5489/cuaj.687

Magliano, E., Grazioli, V., Deflorio, L., Leuci, A. I., Mattina, R., Romano, P., & Cocuzza, C. E. (2012). Gender and age-dependent etiology of community-acquired urinary tract infections. The scientific world journal, 2012. DOI: https://doi.org/10.1100/2012/349597

Minardi, D., d’Anzeo, G., Cantoro, D., Conti, A., & Muzzonigro, G. (2011). Urinary tract infections in women: etiology and treatment options. International journal of general medicine, 333-343. DOI: https://doi.org/10.2147/IJGM.S11767

Khalifa, A., Harb, A., & Alkout, A. (2014). Urinary tract infection in Sobrata, Algmel cities in Libya 2013. Clin Microbial, 3(163), 2.

John, A. S., Mboto, C. I., & Agbo, B. (2016). A review on the prevalence and predisposing factors responsible for urinary tract infection among adults. Euro J Exp Bio, 6(4), 7-11.

Khalifa, K., Ali, M. F., Abo el Ela, O., & El Ayaat, A. (1987). Retrospective two-year study of urinary tract infection in the Ismailia area of Egypt. Chemioterapia: International Journal of the Mediterranean Society of Chemotherapy, 6(2 Suppl), 500-502.

Al Yousef, S. A., Younis, S., Farrag, E., Moussa, H. S., Bayoumi, F. S., & Ali, A. M. (2016). Clinical and laboratory profile of urinary tract infections associated with extended spectrum β-lactamase producing Escherichia coli and Klebsiella pneumoniae. Annals of Clinical & Laboratory Science, 46(4), 393-400.

Khan, M., Shah, S. H., Abdullah, M., Salman, M., Hayat, F., Sarwar, R., ... & Qazi, I. (2022). Current Epidemiological Status and Antibiotic Resistance Profile of Urinary Tract Infection. Journal of Bioresource Management, 9(1), 12.

Lin, J. C., Koh, T. H., Lee, N., Fung, C. P., Chang, F. Y., Tsai, Y. K., ... & Siu, L. K. (2014). Genotypes and virulence in serotype K2 Klebsiella pneumoniae from liver abscess and non-infectious carriers in Hong Kong, Singapore and Taiwan. Gut Pathogens, 6(1), 1-7. DOI: https://doi.org/10.1186/1757-4749-6-21

Varughese, L. R., & Beniwal, V. (2015). High quinolone resistance pattern among enteric pathogens isolated from patients with urinary tract infection.

Sattar, A., Mustafa, K. J., Khan, A. F., & Khan, H. (2019). Uropathogens and their Susceptibility to Common Antibiotics in Adult Patients Presenting to the Emergency Department of a Tertiary Care Hospital in Pakistan. South Asian Journal of Emergency Medicine, 2(2), 29-29. DOI: https://doi.org/10.5455/sajem.020210

Ahmed, I., Sajed, M., Sultan, A., Murtaza, I., Yousaf, S., Maqsood, B., ... & Anees, M. (2015). The erratic antibiotic susceptibility patterns of bacterial pathogens causing urinary tract infections. EXCLI journal, 14, 916.

Nirwati, H., Sinanjung, K., Fahrunissa, F., Wijaya, F., Napitupulu, S., Hati, V. P., Hakim, M. S., Meliala, A., Aman, A. T., & Nuryastuti, T. (2019). Biofilm formation and antibiotic resistance of Klebsiella pneumoniae isolated from clinical samples in a tertiary care hospital, Klaten, Indonesia. BMC proceedings, 13(Suppl 11), 20. https://doi.org/10.1186/s12919-019-0176-7 DOI: https://doi.org/10.1186/s12919-019-0176-7

Yang, D., & Zhang, Z. (2008). Biofilm-forming Klebsiella pneumoniae strains have greater likelihood of producing extended-spectrum beta-lactamases. The Journal of hospital infection, 68(4), 369–371. https://doi.org/10.1016/j.jhin.2008.02.001 DOI: https://doi.org/10.1016/j.jhin.2008.02.001

Hussein, N. R., Assafi, M. S., & Ijaz, T. (2017). Methicillin-resistant Staphylococcus aureus nasal colonisation amongst healthcare workers in Kurdistan Region, Iraq. Journal of global antimicrobial resistance, 9, 78-81. DOI: https://doi.org/10.1016/j.jgar.2017.01.010

Abdulrahman, I. S. (2018). Antimicrobial susceptibility pattern of pathogenic bacteria causing urinary tract infections at Azadi Hospital in Duhok CityKurdistan Region of Iraq. Science Journal of University of Zakho, 6(2), 46-50. DOI: https://doi.org/10.25271/2018.6.2.435

Biradar, S., & Roopa, C. (2015). Isolation and antibiogram of Klebsiella species from various clinical specimens. International Journal of Current Microbiology and Applied Sciences, 4(9), 991-995.

Esan, C. O., Famurewa, O., Lin, J., & Shittu, A. O. (2009). Characterization of Staphylococcus aureus isolates obtained from health care institutions in Ekiti and Ondo States, South-Western Nigeria. Afr J Microbiol Res, 3(12), 962-968.

Assafi, M. S., Hado, H. A., & Abdulrahman, I. S. (2020). Detection of methicillin-resistant Staphylococcus aureus in broiler and broilers farm workers in Duhok, Iraq by using conventional and PCR techniques. Iraqi J Vet Sci, 34(1), 15-22. DOI: https://doi.org/10.33899/ijvs.2019.125757.1145

Gajdács, M., Ábrók, M., Lázár, A., & Burián, K. (2019). Comparative epidemiology and resistance trends of common urinary pathogens in a tertiary-care hospital: a 10-year surveillance study. Medicina, 55(7), 356. DOI: https://doi.org/10.3390/medicina55070356

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01-01-2024

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1.
Abougrara G, alkhboli A, twair F, Shaglabow S. Klebsiella pneumoniae Antibiotic Resistance Pattern Towards Antimicrobial Agents in Urinary Tract Infection Patients in Zawia City / Libya. LJMR [Internet]. 2024 Jan. 1 [cited 2024 Nov. 24];18(1):55-64. Available from: https://ljmr.ly/index.php/ljmr/article/view/132