Epidemiology of Klebsiella Infections at Komfo Anokye Teaching Hospital

Thumbnail Image
Journal Title
Journal ISSN
Volume Title
Different Kiebsiella species may be responsible for various infections which may also differ with the site of the infection. These species may also present with different antimicrobial sensitivity patterns. However, the identification of Kiebsiella to species level is not practiced in most of our hospitals, during bacteriological diagnosis, because of time constraints and labour. In view of these, antibiotics are normally adniinistered o treat Kiebsiella infections without considering the type of species responsible for that particular infection, or site of isolation of the Klebsieiia species. The objective of this project was to determine Kiebsiella species responsible for causing infections, their sensitivity patterns to the commonly used antimicrobial agents and the effectiveness of empirical treatment at KATH. Samples were collected from 2197 patients. These samples were cultured to isolate the Kiebsielia species. Isolates were differentiated to the species level and their antimicrobial sensitivity patterns determined. The empincal treatment on 51 pediatric patients were monitored and compared with the laboratory sensitivity patterns of the isolates. Two hundred and five (205) Kiebsiella species were isolated, these included Kiebsiella pneurnoniae, K. oxyloca, K. rhinoscleroinatis and K. ozaenae. K. pneumoniae and K. oxytoca were the commonest isolates. Prevalence of Kiebsie i/a infections in the commonest clinical specimens were sputum (14.1%), wound (12.6%), urine (10.7%) and blood (5,1%). The highest female cases were found in urine and the male cases were found in sputum. There was no significant difference between the outpatient and in-patient cases and among sexes of Klebsiella infections at Komfo Anokye Teaching Hospital. Mother Baby Unit (MBU) registered 21 Kiebsiella isolates, Block A which accommodates pregnant women recorded 19 Kiebsielia isolates, Block B which accommodates children registered 16 Klebsielia isolates and the pediatric emergency unit (PEU) recordered 1 5 Kiebsiella isolates. Results also indicated that K. pneutnoniae was commonest species, but K. oxytoca was found to be more drug resistant than K. pneumoniae. The study also revealed that, aminoglycosides and third generation cephalosponns were the most effective invitro antimicrobials for managing KlebieIIa infections at KATH. Results gathered from empirical treatment showed that, aminoglycosides and third generation. cephalosporins were the most prescribed antimicrobials for KIebsiella infections. Although empirical treatment is very relevant, it cannot be relied upon completely, but should be combined with laboratory antibiotic sensitivity testing for effective Kiebsie 1/a infection treatment.
A thesis submitted to the Department of Clinical Microbiology in partial fulfillment of the requirement for the award of the Degree in master of Health Sciences