Exploring Antimicrobial Resistance in Extended- Spectrum Β-Lactamase Producing Klebsiella pneumoniae Isolates from Chicken in Kunshan, China and Nairobi, Kenya.

Abstract

ABSTRACTThe World Health Organization (WHO) has declared antimicrobial resistance (AMR) a global health threat. New AMR resistance strains of bacteria have emerged which are associated with high morbidity and mortality rates. AMR has been regarded as a One-Health issue due to its growing concerns for livestock, poultry, and public health. Klebsiella pneumoniae (K.pneumoniae) is a prominent zoonotic bacterium and high prevalence of Extended Spectrum Beta Lactamases K. pneumoniae (ESBL-KP), carbapenem resistant K. pneumoniae (CR-KP) and colistin-resistant K. pneumoniae (COLR-KP) have been reported worldwide. Due to excessive and indiscriminate use of antibiotics in the poultry industry, its Multidrug Resistant (MDR) has increased in recent years. Despite the threat it possesses to the public, limited data exist about its prevalence, and resistance towards first line antimicrobial agents in China and Kenya. The main objective of this study was to investigate the prevalence and antibiotic resistance of K. pneumoniae isolated from chicken in China and Kenya. This cross-sectional study was approved by the Institutional Animal Care & Use Committee (IACUC), Duke Kunshan University, China, and the Institute of Primates Research (IPR) Kenya. A total of 385 cloacal swabs samples (193 from Kunshan and 192 from Nairobi) were collected from live chicken by using sterile cotton swabs during 2022-2023. K. pneumoniae isolates were identified and confirmed by using culture and Polymerase Chain Reaction (PCR) assays while sensitivity testing was done to determine the susceptibility of these isolates to selected antimicrobial agents. The presence of resistant genes was determined by PCR by using standard primers. The Klebsiella species isolation rate was 52.8% (102/193) and 48.4% (93/192) identified by culture but 46.1% (89/193) and 35.9% (69/192) confirmed as K. pneumoniae isolates in Kunshan and Nairobi respectively. There was no significant difference (p>0.05) in the prevalence rate of K. pneumoniae in Kunshan and Nairobi. All the isolates except one were resistant to at least one antimicrobial agent. Resistance towards antimicrobial agents was reported in more than half the samples with high resistance being noted towards Ampicillin (AMP 81.7%), Ciprofloxacin (CIP 60.8%) and Aztreonam (ATM 48.7%). Number of resistant isolates against AMP, CIP, and ATM in Kunshan was significantly higher (p<0.05) than Nairobi. There was significant difference (p<0.05) in the number of sensitive, resistance and intermediate isolates. Antimicrobial sensitivity of ATM, IMP was significantly higher (p<0.05) than antimicrobial sensitivity of AMP, CIP and CTX. MDR isolates of K. pneumoniae observed in this study, however, the pattern of MDR was variable between Kunshan and Nairobi. BlaOXA-1 was the predominant resistant gene, however blaCTX-M, blaNDM-1 were significant. The prevalence of blaOXA-1 among K. pneumoniae isolates was significantly higher (p<0.05) when compared with other resistant genes. A non-significant difference (P>0.05) was observed among ESB-KB, CR-KP and COLR-KP. The prevalence of resistant genes was significantly higher (p<0.05) in Nairobi isolates when compared with isolates from Kunshan. Higher prevalence of K. pneumoniae in Kunshan was attributed to high prevalence of K. pneumoniae, high consumption of poultry products and excess use of antimicrobial agents in poultry. Likewise, prevalence in Nairobi was associated with lack of consultation services and excessive use of antimicrobial agents in both human and companion animals. Findings highlighted the potential role of chicken as a reservoir of K. pneumoniae hence a potential threat to food safety and public health, subsequently to the World Health Organization (WHO) vision 2030 of sustainable health.