Background and Objectives: Carbapenem antibiotic are drug of last-resort from the treatment of bacterial infection, as a result of the prevalence and rapidly evolving enzymes from Carbapenem resistant bacteria such Escherichia coli and Klebsiella pneumoniae make urinary tract infection difficult, and in some cases impossible to treat in health care settings. With limited progress of new antibacterial drugs, the best approach is monitoring the prevalence and antibiogram profile of carbapenem-resistant Escherichia coli and Klebsiella pneumoniae among patients with UTI in Abakaliki, Nigeria. Methodology: A non-repetitive, clean catch mid-stream urine was collected from five hundred (500) diagnosed UTI inpatient and outpatient. The samples were evaluated using routine microbiological protocol for isolation and identification of Escherichia coli and Klebsiella pneumoniae. Phenotypic screening of Carbapenem-resistant strains was performed using Modified Hodge Testing. Antibiogram studies of carbapenem-resistant Escherichia coli and Klebsiella pneumoniae was performed using the Kirby–Bauer disk diffusion method and the results were interpreted using the Clinical Laboratory Standard Institute (CLSI) zone diameter breakpoints. Multiple antibiotic resistance index (MARI) was determined for MDR strain. Result: The prevalence of Escherichia coli and Klebsiella pneumoniae isolate accounted for 148(29.6 %) consisting of 95(54.3 %) and 53(16.3 %) from in-patients and out-patients. Escherichia coli accounted overall isolation rate of 112(22.4 %) comprising of high proportion among in-patient 82(46.9 %) over out-patient 30(9.2 %). The proportion of K.  pneumoniae accounted for 36(7.2 %) with 13(7.4 %) and 23(7.1 %) recorded among in-patients and out-patients. Association between presence of Escherichia coli and Klebsiella pneumoniae isolates in clinical samples was statistically significant with patient’s population with p value <0.05. Carbapenem-resistant Escherichia coli and Klebsiella pneumoniae accounted for 37(7.4 %) comprising of 24(13.7) and 13(4.0 %) among in-patients and out-patients respectively while carbapenem-susceptible Escherichia coli and Klebsiella pneumoniae accounted for overall detection rate of 111(22.2 %) consisting of 71(40.6 %) and 40(12.3 %) among in-patients and out-patients respectively. The isolates resistance rate to cephalosporins were relatively high i.e., Cefotaxime, Cefoxtin Ceftazidime, Ceftriaxone resistance was observed at 60-100% while amoxicillin/clavulanate, azetronam, tetracycline nitrofurantoin and Ticarcillin-clavulanic acid recorded 100 % with MDR index ranged from 0.5-0.8, but were 100 % and 85.0 % sensitive to ciprofloxacin and ofloxacin. Conclusion: These results strongly hypothesize that MDR bacteria, including Carbapenem-resistant isolate, have become common residents in various hospital environments, however with substantial evidence in this study, ciprofloxacin and ofloxacin as drugs of choice could be used for treatment of UTI. Therefore, its importance that good antibiogram evaluation of other drug classes beside fluoroquinoles reported in this study need to be establishes as baseline for empirical diagnosis, epidemiological surveillance, drug prescriptions and infection management.

Background and Objectives: Carbapenemase-producing bacteria are super bugs that make Urinary Tract Infections (UTIs) difficult to treat with drug of last resort such as carbapenem and other antibiotic thus limiting the treatment options. Carbapenemase production is increasing in clinical isolates of E. coli and K. pneumoniae, their potential to spread widely among patients necessitates molecular detection of carbapenemase-producing Escherichia coli and Klebsiella pneumoniae implicated in Urinary Tract Infection. Methodology: A total of twelve (12) non-repeated clinical isolate of Escherichia coli (E1, E2, E3, E4, E5, E6, E7) and Klebsiella pneumoniae (K8, K9, K10, K11, K12) were selected based on their in vitro phenotypic resistant to carbapenem antibiotics from patients diagnosed with urinary tract infection at Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AE-FEUTHA) Ebonyi Sate Nigeria. Escherichia coli and Klebsiella pneumoniae were further confirmed using standard routine microbiological technique for isolation and identification of bacteria. Escherichia coli and Klebsiella pneumoniae strains were further screen for carbapenemase-producing gene by PCR specific primer. Result: PCR analysis with specific primer for carbapenemase gene revealed the presence and predominant of blaKPC in Escherichia coli and Klebsiella pneumoniae 12(100 %) followed by blaNDM 11(91.7 %), blaIMP 7(58.3 %) and blaVIM 2(16.7) as the least carbapenemase-producing gene in Escherichia coli and Klebsiella pneumoniae. blaKPC was predominant in Escherichia coli 7(58.3 %) followed by blaNDM 6(50.0 %) and blaIMP 5(41.7 %) while both blaOXA and blaVIM (16.7 %) were the least detected carbapenemase gene. Klebsiella pneumoniae harbor high proportion of blaNDM and blaKPC both recording 5(41.7 %) followed by blaOXA and blaIMP both recording 2(16.7 %) but blaVIM gene was not identified in Klebsiella pneumoniae. Conclusion: The current findings highlight the occurrence of carbapenemase-producing gene in Escherichia coli and Klebsiella pneumoniae implicated in UTI. Since these genes are carried on the bacteria plasmid there is a tendency of cross-species dissemination over time. The detection of carbapenemase-producing gene call for prompt epidemiological surveillance and preventive strategies to limit the spread of these carbapenemase resistant genetic determinant and the need for antibiotic susceptibility testing of available antibiotic agent.

Background and Objectives: In recent years, the rate of carbapenemase encoding gene in P. aeruginosa has increased worldwide and has become of great concern since it’s significantly restricts the therapeutic options for patients in Tertiary health care. Therefore, there’s a need for molecular characterization of carbapenemase encoding genes in Pseudomonas aeruginosa from Tertiary Healthcare in South Eastern Nigeria. Methodology: A total of twelve (12) Pseudomonas aeruginosa positive culture of Urine (n=5), Wound swab (n=5), Catheter tip (n=2) were collected from Alex Ekwueme Federal University Hospital Teaching Hospital, Abakaliki (AE-FUTHA), Ebonyi State, South eastern Nigeria.  The Pseudomonas aeruginosa strain confirmation was performed using VITEK 2 System and the bacteria were further screen for carbapemase encoding gene by PCR specific primer. Results: Molecular amplification of carbapenemase encoding genes revealed that blaNDM and blaIPM accounted 12 (100%) across all sample source. Among the various sample sources, blaKPC was found 1(8.3%) in Urine, wound swab 3(25.0%), and Catheter tip 1(8.3%), while blaVIM was found 2(16.7%), 2(16.7%) and 0(0.0%) in Urine, wound swab and Catheter tip respectively. Co-expression of blaNDM + blaIMP accounted 5(41.6 %), 5(41.6 %) and 2(16.7 %) in Urine, wound swab and Catheter tip respectively. Co-expression of blaKPC + blaNDM + blaVIM + blaIMP + blaOXA was only detected in urine 1(8.3 %). Conclusion: The current study gives an account of the presence of carbapenemase-encoding genes in P. aeruginosa. The expression of carbapenemase-encoding genes may be the mainstay of phenotypic MDR. As a result, physicians, other medical professionals, researchers, and public health policymakers must be kept up to date on the spread of carbapenemase-encoding genes. In addition, strict infection prevention and control strategies, as well as antimicrobial stewardship programs, are highly desirable in admission healthcare facilities where carbapenemase-encoding genes are spreading.