Extended-spectrum beta-lactamases in clinical isolates of Escherichia coli and Klebsiella pneumoniae recovered from patients at the Tamale Teaching Hospital, Ghana

Introduction Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae are pathogens of significant public health interest for which new antibiotics are urgently needed. Aim To determine the prevalence of ESBLs in E . coli and K . pneumoniae isolates from patients attending the Tamale Teaching Hospital (TTH) in Ghana. Methodology The study was a cross-sectional study involving convenience sampling of E . coli and K . pneumoniae isolates from consenting patients’ clinical specimens, between April and June 2015. Antimicrobial susceptibility test was performed, and ESBL-producer phenotypes were further screened for Bla TEM , Bla SHV , and Bla CTX-M genes. Patients’ clinical data were additionally collected using a structured questionnaire. Results Of the 150 non-duplicate E . coli and K . pneumoniae isolates identified, 140 were confirmed as E . coli (84%, n = 117) and K . pneumoniae (16%, n = 23). Of these, sixty-two (44%) [ E . coli (84%; n = 52); K . pneumoniae (16%; n = 10)] phenotypically expressed ESBLs. The proportion of ESBL-producing isolates was higher in adults (15–65 years) than in neonates (< 28 days) ( p = 0.14). Most of the isolates showed a high percentage resistance to ampicillin (96%) and tetracycline (89%), but a relatively lower resistance to amikacin (36%). No isolate was resistant to meropenem. More ESBL producers were multidrug resistant compared to non-ESBL-producers [23% (14/62) versus 18% (14/78); p = 0.573]. Overall, 74% ( n = 46) of the ESBL genotypes expressed Bla CTX-M-1 genes, followed by 63% ( n = 39) Bla TEM , and 16% ( n = 10) Bla SHV . The study showed a high prevalence of ESBL-positive E . coli and K . pneumoniae , mostly CTX-M-1 producers at TTH. Conclusion Routine laboratory ESBL screening is warranted to inform patient management.