ANTIBIOTIC SUSCEPTIBILITY OF ESBL KLEBSIELLA WOUND ISOLATES IN PATIENTS ATTENDING NATIONAL ORTHOPAEDIC HOSPITAL, ENUGU, NIGERIA

The antibiotic resistance of microorganisms has been a public health issue due to its role in the dissemination of pathogens as well as mutant and resistant genes in human. The purpose of this study was to evaluate the antibiotics resistance of Extended Spectrum Beta Lactamase (ESBL) Klebsiella producers in patients attending clinic in National Orthopaedic Hospital, Enugu, Enugu State, Nigeria. Methodology: A Cross sectional study was employed for this research. A total of 230 participants (male and female) of different age groups were recruited using convenient sampling technique. Non duplicate wound swabs were collected from each participant. Results: Five Klebsiella species isolated were ESBL producers and Klebsiella pneumoniae was prevalent with 75%, followed by Klebsiella oxytoca 10%. The extended spectrum beta lactamase (ESBL) Klebsiella producers were identified using the Combination technique and Double synergy of both ESBL and Non ESBL antibiotics. All the ESBL Klebsiella producers were resistant to ampicillin 10 (100%), followed by tetracycline 8 (100%) and imipenem 7 (100%) respectively and the least resistance was amikacin 1 (100%). The double synergy testing of ESBL resistant Klebsiella species with Amoxyillin clavulanic acid (AMC) showed no significant different as p>0.990, while the ESBL resistant Klebsiella had a significant difference with Piperacillin tozabactam (TPZ) as p<0.001. The Multiple antibiotics Resistance Index (MARI) of resistant ESBL Klebsiella producers was above the normal value of 0.2. Conclusion: Extended beta lactamase resistant Klebsiella species have been isolated in Orthopaedic wound swabs which contributed to the spread of antibiotics resistance in patient"s samples. There is need to adhere to guidelines in antibiotics administration and usage in order to minimize the spread of nosocomial infections and resistant genes. Proper sanitation and personal hygiene is also advocated to aid in proper wound healing.