Molecular detection and antibiotic resistance pattern of extended-spectrum beta-lactamase producing Escherichia coli in a Tertiary Hospital in Enugu, Nigeria

Abstract

BackgroundThe use of antibiotic agents in the treatment of infectious diseases has greatly contributed to the decrease in morbidity and mortality, but these great advances in treatment are being undermined by the rapidly increasing antimicrobial resistant organisms. Extended-spectrum beta-lactamases are enzymes hydrolyzing the beta lactam antibiotics, including third generation cephalosporins and monobactams but not cephamycins and carbapenems. They pose a serious global health threat and have become a challenge for health care providers. The aim of this research was to assess the prevalence of extended-spectrum beta-lactamase producing Escherichia coli in University of Nigeria Teaching Hospital Ituku-Ozalla Enugu and to detect the risk factors for acquisition of the resistant organism. To proffer advice on antibiotic stewardship in clinical practice and public health interventions, to curb the spread of the resistant organisms in the hospital.ResultsOut of the 200 E. coli isolates, 70 (35.00%) were confirmed positive for extended-spectrum beta-lactamase production. Fifty-three (75.7%) were from hospital acquired infections. All the isolates were resistant to ampicillin, tetracycline and chloramphenicol while 68 (97.14%) of the 70 isolates were susceptible to imipenem. BlaTEM, blaSHV and blaTEM were detected in 66 (94%) of the 70 isolates. The ESBL bla genes detected were blaCTX-M (n = 26; 37.14%), blaTEM (n = 7; 10.00%), blaSHV (n = 2; 2.86%), blaCTX-M/TEM (n = 7; 10.0%), blaCTX-M/SHV (n = 14; 20.0%) and blaCTX-M/TEM/SHV (n = 10; 14.29%). The three bla genes were not detected in 4 (5.71%) of the isolates. Recent surgery, previous antibiotic and intensive care unit admission were the associated risk factors to infections caused by extended-spectrum beta-lactamase producing E. coli.ConclusionThere is a high rate of infections caused by extended-spectrum beta-lactamase producing E. coli. Recent surgery, previous antibiotic and intensive care unit admission were associated risk factors.

Antimicrobial resistance in hospitalized surgical patients: a silently emerging public health concern in Benin

“…These challenges have been made even greater by methicillin-resistant Staphylococcus aureus (MRSA), extended spectrum beta-lactamases (ESBL) producing Enterobacterales, and the involvement of polymicrobial flora and fungi [ 7 , 8 ]. ESBL have been reported most often in Escherichia coli and Klebsiella spp., but also in other bacterial species such as Pseudomonas aeruginosa, and Enterobacter cloacae [ 9 ] .…”

Antimicrobial resistance in hospitalized surgical patients: a silently emerging public health concern in Benin

“…These challenges have been made even greater by methicillin-resistant Staphylococcus aureus (MRSA), extended spectrum betalactamases (ESBL) producing Enterobacteriales, and the involvement of polymicrobial ora and fungi [7,8]. ESBL have been reported most often in Escherichia coli and Klebsiella spp., but also in other bacterial species such as Pseudomonas aeruginosa, and Enterobacter cloacae [9].…”

Phylogroup profiling and the genetic determinants of extended spectrum beta-lactamase producing Escherichia coli isolated from clinical samples in lagos, Nigeria

“…The common resistance genes associated with ESBL production and multi-drug resistance in E. coli are plasmid-borne and are designated as . Carriage of these genes by ESBL producing E. coli at varying prevalence rates in different settings have previously been reported in Nigeria (Raji et al, 2013;Hertz et al, 2019;Nwafia et al, 2019a), albeit their phylotypes have not been elucidated.…”

“…Extended spectrum beta-lactamase (ESBL) producing Escherichia coli (E. coli) infections is a public health threat because these infections are difficult to manage due to multiple antibiotic resistance, leading to the availability of only a few antibiotics, that are effective against the infections. E. coli strains are normal flora of the gastrointestinal tract but can also cause serious infections in humans ranging from urinary tract infections (Onanuga et al, 2019), surgical site infections to sepsis globally (Adenipekun et al, 2016;Nwafia et al, 2019a). This situation is compounded by their resistance to the third generation cephalosporins which are commonly used to treat associated infections (Umeokonkwo et al, 2019).…”