Multidrug Resistance in Klebsiella species Isolated from Liquid Herbal Remedies in Port Harcourt, Nigeria

Aims: Klebsiella are lactose fermenting, encapsulated, non-motile, oxidase-negative, gram negative rods; belonging to the family Enterobacteriaceae and the non-taxonomic group, coliforms. Klebsiella isolates numbering 109, recovered from three categories of liquid herbal medicines were analyzed with the intent of ascertaining the prevalence of multidrug resistance (MDR) strains.

Study Design: The research is an observational, descriptive, prospective and cross-sectional research. The samples of herbal remedies procured from randomly selected outlets within Port Harcourt metropolis in a completely randomized block design. The analysis was conducted at the Department of Microbiology laboratory of Rivers State University, Port Harcourt, Rivers State, Nigeria.

Methodology: The antimicrobial resistance (AMR) patterns of Klebsiella pneumoniae and Klebsiella oxytoca were determined against 15 antimicrobial agents in common use in the area, namely amoxicillin clavulanate(30ug/ul), ceftriaxone (30ug/ul), cefuroxime (30ug/ul), cephalexin (30ug/ul), chloramphenicol (30ug/ul), ciprofloxacin (5 ug/ul), cotrimoxazole (25ug/ul), doxycycline (30ug/ul), erythromycin (15 ug/ul), gentamycin (10 ug/ul), levofloxacin (5 ug/ul) norfloxacin (10 ug/ul), ofloxacin (5 ug/ul), peflacine (5 ug/ul), streptomycin (10 ug/ul) (0xoid/Thermo Fisher Scientific, UK).; by seeding the test isolates on Muellar-Hinton agar (oxoid) and incubating for 18 to 24 hours.

Results: The cumulative resistance profile for all strains was 45.4%. Doxycycline was the least effective antimicrobial, being resisted by 63.3% of the strains, followed by cotrimoxazole (61.5%), erythromycin (58.7%), chloramphenicol (57.8%) and norfloxacin (50.0%). Overall, 82.6% of the Klebsiella strains were MDR, including extensively drug resistant-XDR, (52.3%) and pandrug resistance-PDR (1.8%). Non-multidrug resistant-NMDR strains were 16.0%. MDR strains constitute 81.6% of Klebsiella pneumoniae which includes XDR (48.8%) and PDR (2.0%); while NMDR strains were 18.4%. The MDR strains amounted to 90.9% of the Klebsiella oxytoca strains all of which were XDR.

Conclusion: This study has contributed in establishing that liquid herbal remedies are contaminated with multidrug resistant strains of Klebsiella Species. It has also shown that multidrug resistant strains of the bacteria are on the increase and could pose a great threat to public health.