Background: The emergence and spread of extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae is now a major challenge in treating urinary tract infections. This study was conducted to determine the Prevalence of ESBL genes in Klebsiella pneumoniae and the influence of these genes on the antimicrobial susceptibility patterns of the isolates, obtained from community acquired urinary tract infection in Enugu state rural communities. Method: A total of 735 clean catch mid-stream urine samples were collected from February, 2021 to June, 2021. The urine samples were cultured and Klebsiella pneumoniae were identified morphologically, biochemically, and then typed down, using PCR, Gel electrophoresis, and Sanger Sequencing by Genewiz. Antibiotic susceptibility testing was done by modified Kirby-Bauer disc diffusion method and interpretation was done following Clinical and Laboratory Standard Institute (CLSI) guidelines. ESBL screening was done by the phenotypic method, using the standard disk diffusion method, whereas the phenotypic confirmation of ESBL producers was done by the double-disk synergy method, and interpreted according to CLSI guidelines. Multiplex PCR was used to detect the genes for SHV and CTX-M while conventional linear PCR was done for TEM and blas GES type ESBL genes. Results: A total of 77 isolates were identified as Klebsiella pneumoniae, and the prevalence of positive ESBL in them were 10(12.9%). Of the 77 isolates that were tested for antibiogram, 29 isolates were multidrug-resistance (MDR). Out of the MDR isolates, 10 were ESBL positive, whereas 19 were not. Of this 29 MDR isolates, 6 were extensively-drug resistant (XDR). Of the 6 XDR isolates, 3 do not possess ESBL enzymes, whereas 3 of them do. Age range of 31-40 contributed the highest prevalence of ESBL genes (60%), whereas age range of 10-20, 21-30, and 51-70 did not produce any ESBL gene. bla TEM gene was the most prevalent ESBL resistant genes with a prevalence of 10 (100%), followed by SHV 9(90%), whereas bla GES gene and bla CTX-M have the least prevalence of 4 (40%) each. Conclusion: Higher prevalence of MDR, XDR, and ESBL-producing Klebsiella pneumoniae were observed, thus the need for public health intervention for effective prevention and control of antimicrobial resistance, and proper treatment of UTIs.

Urinary tract infection (UTI) is the infection of any part of the urinary tract, and about 150 million people worldwide develop UTI each year. Its is caused by bacteria, though fungi and viruses are etiologic agents, and can occur in community and hospital settings. This study was conducted to determine the epidemiology of pathogens causing urinary tract infections in Rural Communities of Enugu State, Nigeria. A total of 735 clean catch mid-stream urine samples were collected and tested for bacteriuria from February, 2021 to June, 2021. The participants were assessed clinically to ascertain eligibility for participation, and urine samples were assessed microbiologically to isolate pathogens causing UTI. Pathogens isolated were identified morphologically, and biochemically, and results were tabulated, with respect to participants demographics. Total number of participants that participated in urine culture was 735, of this number, 172(23.40%) were males, whereas 563(76.60) were females. 510(69.39%) were married whereas 225(30.61%) were single. Total number of bacterial isolates obtained was 649 (88.30%).  Of this, Escherichia coli was the most prevalent, 316 (48.7%), followed by Staphylococci, 154 (27.7%). The least represented isolate was Pseudomonas, 2 (0.3%). Of the total number of isolates obtained, 151(23.27%) came from males, whereas 498 (76.73%) were from females. Total number of married participants with positive bacteriuria was 449 (69.18%), and those of them that were single constituted 198(30.51%). Age range of 31-40 gave the highest level of bacteriuria 151 (23.27%), followed by age range of 21-30, 146 (22.50%). The least representation of bacteriuria was seen among age group 10-20, 39(6.01%). The prevalent of UTI in this study was high, and females, youths, and married people showed a positive correlation with community acquired urinary tract infection. Intermittent screening of rural dwellers for positive bacteriuria, with emphasis paid on clinical symptoms and proper treatment will go a long way in tackling the menace of urinary tract infection in our rural communities.

Antibiotic resistance possesses a serious challenge in the treatment of Urinary Tract Infections (UTIs). This study was therefore designed to determine the antibiogram of K. pneumoniae isolated from individuals presenting with UTIs in communities within Enugu state. A cross-sectional study was conducted from February, 2021 to June, 2021 and a total of 735 patients with community-acquired UTIs in Enugu state, Nigeria, were involved in the study. The patients were assessed clinically and microbiologically for Klebsiella pnuemoniae and antibiogram of the isolates were investigated. Out of 77 isolates of Klebsiella pneumaniae obtained, 29 (37.7%) showed multiple resistant to the antibiotics used, whereas 48 (62.3%) were either susceptible or intermediate. Of all the antibiotics tested, meropenem showed the highest recorded sensitivity to the test organism 63(19.93%), whereas the least sensitivity was observed in co-amoxiclav 11 (3.48%). Antibiogram of urinary K. pneumoniae isolated from rural dwellers showed a significantly high resistance to commonly used antibiotics; thus, the need for regular awareness campaign and antimicrobial resistance surveillance to increase knowledge, improve infection control measures, and check abuse of antibiotics.