Epidemiology Of Klebsiella Infections At Komfo Anokye Hospital.

Abstract

Different Klebsiella species may be responsible for various infections which may also differ with the site of the infection. These species may also present with different antimicrobial sensitivity patterns. However, the identification of Klebsiella to species level is not practiced in most of our hospitals, during bacteriological diagnosis, because of time constraints and labour. In view of these, antibiotics are normally administered to treat Klebsiella infections without considering the type of species responsible for that particular infection, or site of isolation of the Klebsiella species. The objective of this project was to determine Klebsiella species responsible for causing infections, their sensitivity patterns to the commonly used antimicrobial agents and the effectiveness of empirical treatment at KATH. Samples were collected from 2197 patients. These samples were cultured to isolate the Klebsiella species. Isolates were differentiated to the species level and their antimicrobial sensitivity patterns determined. The empirical treatment on 51 pediatric patients were monitored and compared with the laboratory sensitivity patterns of the isolates. Two hundred and five (205) Klebsiella species were isolated, these included Klebsiella pneumoniae, K. oxytoca, K. rhinoscleromatis and K. ozaenae. K. pneumoniae and K. oxytoca were the commonest isolates. Prevalence of Klebsiella infections in the commonest clinical specimens were sputum (14.1%), wound (12.6%), urine (10.7%) and blood (5.1%). The highest female cases were found in urine and the male cases were found in sputum. There was no significant difference between the out-patient and in-patient cases and among sexes of Klebsiella infections at Komfo Anokye Teaching Hospital. Mother Baby Unit (MBU) registered 21 Klebsiella isolates, Block A which accommodates pregnant women recorded 19 Klebsiella isolates, Block B which accommodates children registered 16 Klebsiella isolates and the pediatric emergency unit (PEU) recordered 15 Klebsiella isolates. Results also indicated that K. 11pneumoniae was commonest species, but K. oxytoca was found to be more drug resistant than K. pneumoniae. The study also revealed that, aminoglycosides and third generation cephalosporins were the most effective invitro antimicrobials for managing Klebsiella infections at KATH. Results gathered from empirical treatment showed that, aminoglycosides and third generation cephalosporins were the most prescribed antimicrobials for Klebsiella infections. Although empirical treatment is very relevant, it cannot be relied upon completely, but should be combined with laboratory antibiotic sensitivity testing for effective Klebsiella infection treatment.