MST-Department of Pharmacy & Complementary / Alternative Medicine

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Browsing MST-Department of Pharmacy & Complementary / Alternative Medicine by Subject "Klebsiella Pneumoniae"

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    Klebsiella Pneumoniae Prevalence, Antibiotic Susceptibility and Social Demographic Factors Among Patients with Nosocomial Infections in Kiambu County, Kenya
    (Kenyatta University, 2021) Kibuchi, Mwangi Joseph; Scholastica Gatwiri Mathenge
    Klebsiella pneumoniae is regarded as a major contributor to nosocomial infections and it has led to medical conditions such as soft tissue infections and sepsis. This microorganism is spread through fecal oral route and contamination from health care workers. The overall goal of this research was to establish prevalence of Klebsiella pneumoniae among inpatients admitted at African Inland Church, Kijabe Hospital, Kiambu County. The study involved inpatients suspected to have acquired bacterial infection, 48 hours after hospital admission as per World Health Organization case definition. A descriptive cross-sectional study design included 384 participants. Study participants were recruited using the systemic random sampling method. Cerebral spinal fluid, urine and blood were collected and inoculated on the MacConkey, chocolate, Cystine-Lactose-Electrolyte-Deficient agar, and blood agar culture media. All Klebsiella species were subjected to analytical profile index, and susceptibility testing. The findings showed that 18 (4.7%) of the patients were males and had Klebsiella pneumoniae infection while 82(21.4 %) males had no Klebsiella pneumoniae infection. About 10 (2.6%) of the females had Klebsiella pneumoniae while 274 (71.3 %) were females and did not have Klebsiella pneumoniae infection. The study indicated that 28 out of 384 patients developed Klebsiella pneumoniae making a prevalence of 7.29%. About 21 patients (75.0%) were from pediatric ward, 5 patients (17.9%) were from newborn unit, and 2 patients (7.1%) were from intensive care unit. Antimicrobial susceptibility testing showed five blood samples had Klebsiella. Pneumoniae with a total resistance to Ampicillin, while other isolates revealed resistance to Cefazolin, Ceftadime and Ceftriaxone as 83%, 98%, and 86% respectively. Blood and Cerebral Spinal Fluid samples that tested positive were subjected against a total of 14 antibiotics and positive Klebsiella pneumoniae urine sample subjected to a total of 13 antibiotics. Besides Ampicillin other antibiotics with highest resistance included Ceftadime and Cefazolin .Isolates from urine, Cerebral Spinal Fluid and blood revealed almost the same susceptibility when tested against antibiotics, Meropenem showed the least antibiotic resistance represented by 7%, 6% and 0% respectively. Other antibiotics with the least resistance in urine samples included Amikacin 25%, Nitrofurantoin 36% and Chloramphenicol 39%. Analysis of variance was used to assess the difference in antibiotics resistance in Klebsiella pneumoniae isolates and found a significant difference with a mean of 5.547 at 0.05. Findings from this study showed that Klebsiella pneumoniae with multidrug resistance was isolated in the cases with nosocomial infections. Based on this study Klebsiella pneumoniae prevalence at African Inland Church Kijabe Hospital was 7.29%. Meropenem, exhibited the highest sensitivity outcomes as compared to other drugs with respect to isolated microorganisms. Despite a large number of inpatients were using prophylactic drugs, majority had either developed antibiotic resistance or had multiple resistance to antibiotics, thus rendering patients to infections mostly hospital acquired infections. This study recommends regular audits of antimicrobial resistance and surveillance reports to enable frequent update of antimicrobial formulas.