Emergence of Klebsiella pneumoniae strains with reduced susceptibly against 3rd generation cephalosporins and carbapenems in Lagos hospitals, Nigeria.

Different samples (i.e. stool, blood, urine, sputum, wound swabs, nasal swabs etc.) from 127 patients with suspected gram-negative infections based on on-site performed Gram-stain from four public hospitals between March and September 2015 in Lagos, Nigeria were analysed. Klebsiella (K.) pneumonia was identified in 43 (34%) patients. Resistance rates of these 43 strains according to the CLSI breakpoints were as followed: cotrimoxazole (90.7%), cefuroxime (74.4%), ofloxacin (55.8%), ceftazidime (46.5%), and cefixime (35%). Three isolates (7%) were resistant to imipenem. All isolates were susceptible to amoxicillin/clavulanic acid and nitrofurantoin. The prevalence of ESBL-producing and carbapenem resistant strains (CRKP) was 69.8% and 7.0%, respectively. Of the ESBL producing isolates, two K. pneumoniae isolates obtained from urine harbored both blaCTX-M-1 and blaSHV and a third isolate from urine harbored only blaCTX-M-1. Emerging of CRKP strains is an early warning signal for the prudent use of carbapenem antibiotics in concern to their efficacies.