Frequency and Antimicrobials Resistance of Klebsiella pneumoniae Isolated from Patients with Community-acquired Urinary Tract Infections

Abstract

This study was carried out in Khartoum state during the period from November 2008 to March 2009, to study frequency and antimicrobials resistance of Klebsiella pneumoniae isolated from patients with community- acquired urinary tract infections. Two hundred and two urine specimens were collected from patients attended Khartoum Teaching Hospital and Gaffer Iben Auff specialize Hospital for Children. The specimens were cultured on blood agar and MacConkey's agar for primary isolation of pathogen. Identification of the isolates was done by colonial morphology, gram stain and biochemical tests using API E 20. Modified Kirby-Bauer disc diffusion method was adopted to evaluate the resistance rate of K. pneumoniae to nitrofuratoin, amoxycillin, nalidixic acid, co-trimoxazole, amoxyclav, chloramphenicol, ceftriaxone, ciprofloxacin and amikacin. Minimum Inhibitory Concentration (MIC) of nitrofuratoin, nalidixic acid, co-trimoxazole, amikacin and chloramphenicol were determine by E. test. Of the two hundred and two urine specimens examined, 13 (11.9 %) K. pneumoniae were recovered. The results revealed that the antimicrobial resistance of K. pneumoniae was as follows: amoxycillin (100 %), nitrofuratoin (69.2 %), nalidixic acid, co- trimoxazole, amoxyclav, ceftriaxone, ciprofloxacin were (61.5 % each), chloramphenicol (38.5 %) and amikacin (0 %). The result indicated that the MIC, MIC50 and MIC90 of nitrofuratoin (>240 μg/ml each), nalidixic acid (0.05- >240μg/ml, >240 μg/ml and >240 μg/ml ) chloramphenicol (0.01- >240μg/ml 0.1 μg/ml and >240 μg/ml ), co-trimoxazole (0.5->240μg/ml, >240 μg/ml and >240 μg/ml) and amikacin (0.1-2.0 μg/ml,0.5

μg/ml and >30 μg/ml ). The study concluded that the responsibility of K. pneumoniae of community acquired urinary tract infection slightly high. The antimicrobial resistance of K. pneumoniae to traditionally used antibiotics was high too.