Phenotypic and genotypic detection of carbapenemase-producing Escherichia coli and Klebsiella pneumoniae in Accra, Ghana
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Date
2022
Journal Title
Journal ISSN
Volume Title
Publisher
PLOS ONE
Abstract
Aim
To describe the occurrence of carbapenem resistance among multidrug-resistant (MDR)
Escherichia coli and Klebsiella pneumoniae isolated from clinical specimens in Accra using
phenotypic and genotypic methods.
Methodology
The study was cross-sectional, involving 144 clinical MDR E. coli and K. pneumoniae isolates recovered from the Central Laboratory of the Korle Bu Teaching Hospital (KBTH). The
isolates were re-cultured bacteriologically, identified using standard biochemical tests, and
subjected to antibiotic susceptibility testing using the Kirby-Bauer method. Carbapenem
resistance was determined based on imipenem, meropenem, and ertapenem zones of inhibition, as well as minimum inhibitory concentrations (MICs). Carbapenemase production
was determined phenotypically by modified Hodge test (MHT) and modified carbapenem
inactivation method (mCIM), and genotypically with multiplex PCR targeting the blaKPC,
blaIMP, blaNDM, blaVIM, and blaOXA-48 genes.
Results
Of the 144 MDR isolates, 69.4% were E. coli, and 30.6% were K. pneumoniae. The distribution of antimicrobial resistance rates among them was ampicillin (97.2%), cefuroxime
(93.1%), sulfamethoxazole-trimethoprim (86.8%), tetracycline (85.4%), cefotaxime and cefpodoxime (77.1% each), amoxicillin-clavulanate (75%), ceftriaxone (73.6%), ciprofloxacin
(70.8%), levofloxacin (66.0%), cefepime (65.3%), ceftazidime (64.6%), gentamicin (48.6),
piperacillin-tazobactam (40.3%), cefoxitin (14.6%), amikacin (13.9%), ertapenem and meropenem (5.6% each), and imipenem (2.8%). In total, 5.6% (8/144) of them were carbapenem-resistant (carbapenem MIC range = 0.094–32.0 μg/ml), with 75% (6/8) of these testing
Description
Research Article
Keywords
Citation
Citation: Dwomoh FP, Kotey FCN, Dayie NTKD, Osei M-M, Amoa-Owusu F, Bannah V, et al. (2022) Phenotypic and genotypic detection of carbapenemase-producing Escherichia coli and Klebsiella pneumoniae in Accra, Ghana. PLoS ONE 17(12): e0279715. https://doi.org/10.1371/journal. pone.0279715