Antimicrobial resistance of clinical and environmental klebsiella pneumoniae isolates in selected areas of Lusaka, Zambia

Klebsiella pneumoniae causes community / nosocomial infections in humans. In animals it causes mastitis, resulting in low milk productions and deaths. There is emerging, increase, progressive spread of AMR strains in healthcare settings. This poses public health risk and   drain on national financial resources. A cross-sectional study was conducted from July 2019 to January 2021 to evaluate clinical / environmental isolates from selected areas of Lusaka, identify their resistomes conferring resistance. Clinical / environmental samples were processed to isolate K. pneumoniae. Biochemical tests for presumptive identifications followed by confirmation with PCR. ASTs including identifying ESBLs / Carbapenemases producing isolates were achieved by Vitek®2 cards GN 86.  1782 clinical, 1248 environmental samples were processed for isolations, yielded 150 isolates. Hospital environmental isolates had highest resistance to ampicillin-sulbactam 10/10 (100%) and ampicillin 9/10 (90%). Clinical samples’ isolates had highest resistance to ampicillin 72/81(88.9%) and cephazolin 67/81(81.5%). Industrial wastewater isolates had highest resistance to ampicillin 12/12 (100%) but cephazolin, cefuroxime, ceftazidime, ceftriaxone, cefepime all with a resistance of 8/12 (66.7%). No resistance from this source as for ertapenem (0.0%) and imipenem (0.0%). Community water source isolates had ampicillin 39/42 (92.9%) and amoxicillin-clavulanic acid 22/42 (52.4%). Vegetable/salads isolates had ampicillin 5/5 (100%), tetracycline 2/5 (40%), and sulphamethoxazole/trimethoprim 2/5 (40.0%) observed. The high levels of AMR isolates observed in this study are of medical and public health concern. Hence the need to enhance infection prevention and control in health facilities, and implement AMR surveillance for K. pneumoniae in humans and environments. Key words: AMR, Klebsiella pneumoniae, clinical, environment, hospital, community, Lusaka.