Phenotypic Detection and Susceptibility Pattern for the Detection of Extended Spectrum β-Lactamase-Producing Klebsiella pneumonia Isolates in Nairobi, Kenya*


Klebsiella pneumoniae is an opportunistic pathogen that is an important cause of nosocomial infections. Detection of ESBL producers’ poses a special challenge for clinical microbiology laboratories, although ESBL producing pathogens are able to hydrolyze extended-spectrum penicillins, cephalosporins, and aztreonam, the minimum inhibitory concentrations (MIC) of some and perhaps even all of these agents may be within the susceptible range. The third generation cephalosporins have the reputation for being useful against a broad range of bacterial infections. However, resistance to these agents is something that must still be considered and creates obstacles for their clinical use. A total of 80 multi drug resistant clinical isolates of Klebsiella pneumoniae were obtained from a study on anaerobes associated with Pelvic Inflammatory disease (P.I.D), KEMRI S.S.C No.495. The isolates were identified by standard microbiological procedures. Antimicrobial susceptibility testing was carried out by Kirby-Bauer method. Upon identification, the antibiogram profiles of the isolates were determined and those resistant to third-generation cephalosporins were tested for production of ESBL. ESBL production among the multi drug resistant isolates was detected using the phenotypic confirmatory disc diffusion test (PCDDT) and double disk synergy test (DDST). While using standard double disk synergy test (DDST) as screening method for identifying potential ESBL producers, ceftriaxone was the most efficient antimicrobial in screening isolates as potential ESBL producers followed by cefotaxime.

Share and Cite:

P. Ndiba, "Phenotypic Detection and Susceptibility Pattern for the Detection of Extended Spectrum β-Lactamase-Producing Klebsiella pneumonia Isolates in Nairobi, Kenya*," Open Journal of Medical Microbiology, Vol. 3 No. 2, 2013, pp. 91-94. doi: 10.4236/ojmm.2013.32014.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] P. M. Bennet and T. G. B. Howe, “Bacterial and Bacteriophage Genetics,” Topley and Wilson Principles of Bacteriology, Virology and Immunity, Vol. 1, General Microbiology and Immunity, Edward Arnold, London, 1990, pp 153-210.
[2] L. A. Mitscher, “Antibiotics and Antimicrobial Agents,” In: W. O. Foye, T. L. Lemke and D. A. Williams, Eds., Principles of Medicinal Chemistry, Williams and Wilkins, Philadelphia, 1995, pp. 764-802.
[3] S. Kariuki, J. E. Corkill, G. Revathi, R. Musoke and C. A. Hart, “Molecular Characterization of a Novel Plasmid-Encoded Cefotaximase (CTX-M-12) Found in Clinical Klebsiella pneumoniae Isolates from Kenya,” Antimicrobial Agents and Chemotherapy, Vol. 45, No. 7, 2001, pp. 2141-2143. doi:10.1128/AAC.45.7.2141-2143.2001
[4] National Committee for Clinical Laboratory Standards, “Performance Standards for Antimicrobial Susceptibility testing, 15th Informational Supplement,” NCCLS Antimicrobial Susceptibility Testing Standards M2-A8 and M7-A6, 2005.
[5] J. N. Muthotho, P. G. Waiyaki, M. Moninda and J. Karuri, “International Congress for Infectious Diseases,” Montreal, 1990, Abstract No. 569.
[6] C. Brun-Buisson, P. Legrand, A. Philippon, F. Montravers, M. Ansquer and J. Duval, “Transferable Enzymatic Resistance to Third Generation Cephalosporins during Nosocomial Outbreak of Multiresistant Klebsiella pneumonia,” Lancet, Vol. 2, No. 8554, 1987, pp. 302-306. doi:10.1016/S0140-6736(87)90891-9
[7] A. Palucha, B. Mikiewiez, W. Hryniewiez and M. Griad-kowski, “Concurrent Outbreaks of Extended Spectrum β-Lactamase Producing Organisms of the Family Entero-bacteriaceae in a Warsaw Hospital,” Journal of Antimicrobial Chemotherapy, Vol. 44, No. 4, 1999, pp. 489-499. doi:10.1093/jac/44.4.489
[8] G. W. Procop, M. J. Tuohy, D. A. Wilson, D. Williams, E. Hadziyannis and G. S. Hall, “Cross-Class Resistance to Non-Beta-Lactam Antimicrobials in Extended-Spectrum Beta-Latamase-Producing Klebsiella pneumonia,” American Journal of Pathology, Vol. 120, No. 2, 2003, pp. 265-267.

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.