Prevalence and Antibiotic Resistance Patterns of Pseudomonas aeruginosa, Klebsiella pneumoniae and Escherichia coli among Hospitalized Patients at Thika Level 5 Hospital

Abstract

The rise of antibiotics resistance is a global public health challenge, particularly in the context of hospital-acquired infections. Pathogens such as Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli play a significant role in nosocomial infections. This study assessed the carriage rates, antibiotic resistance patterns, and the presence of genes conferring resistance of these pathogens to β-lactams, aminoglycosides, and (fluoro) quinolones. Conducted at Thika Level 5 Hospital in Kiambu County, the cross-sectional study spanned five months. Pus swabs from surgical and burn wounds along with aseptically collected urine samples from catheterized inpatients were collected and analyzed. Isolates were identified through biochemical and serological tests following specimen culture. Antibiotic susceptibility testing was performed using the Kirby-Bauer disc diffusion method, with interpretation based on recommendations from the Clinical Laboratory Standards Institute. Genes encoding resistance to the three main classes of antibiotics were detected using Polymerase Chain Reaction. A total of 450 specimens were collected, yielding 42 E. coli, 41 K. pneumoniae, and 41 P. aeruginosa isolates. Importantly, 4.9% of P. aeruginosa, 7.1% of E. coli, and 14.6% of K. pneumoniae isolates demonstrated resistance to carbapenems. Additionally, resistance of isolates to sulfamethoxazole-trimethoprim was E. coli (78.6%), K. pneumoniae (46.3%), and P. aeruginosa (29.3%) isolates being classified as multidrug-resistant. Resistance genes were detected using PCR: aminoglycoside phosphotransferase (aph (3’)III) ββat 17% in E. coli and 7% each for P. aeruginosa and K. pneumoniae. Prevalence of blaTEM for E. coli, P. aeruginosa, and K. pneumoniae was 10 %, 20 % and 24% respectively. Integrons in P. aeruginosa and K. pneumoniae were each at 20%, and at 33% for E. coli. In conclusion, the study highlights significant resistance to commonly used antibiotics including last- resort options like carbapenems. Routine antibiotic susceptibility testing and surveillance are crucial for managing wound and urinary tract infections, especially due to MDR.