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Emergence of Klebsiella pneumoniae strains with reduced susceptibly against 3rd generation cephalosporins and carbapenems in Lagos hospitals, Nigeria.
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  • Kabiru Akinyemi,
  • Rebecca Abegunrin,
  • Bamidele Iwalokun,
  • Christopher Fakorede,
  • Oliwia Makarewicz,
  • Heinrich Neubauer,
  • Mathias Pletz,
  • Gamal Wareth
Kabiru Akinyemi
Lagos State University
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Rebecca Abegunrin
Lagos State University
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Bamidele Iwalokun
Nigerian Institute of Medical Research
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Christopher Fakorede
Lagos State University
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Oliwia Makarewicz
Jena University Hospital
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Heinrich Neubauer
Friedrich-Loeffler-Institut Bundesforschungsinstitut für Tiergesundheit
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Mathias Pletz
Jena University Hospital
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Gamal Wareth
Friedrich-Loeffler-Institut Bundesforschungsinstitut fur Tiergesundheit
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Abstract

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.