Prevalence and antibiotic susceptibility of AmpC and ESBLs producing clinical isolates at a tertiary health care center in Kano, north-west Nigeria

Abstract

The increase in production of Extended Spectrum Beta Lactamase (ESBL) and Amp C beta lactamase among clinical isolates in our hospitals is of utmost importance. Failure to detect these enzymes in many of our hospitals has greatly led to treatment failure and uncontrolled spread of multi drug resistant pathogens. It was for this purpose that the present study was conducted to determine the prevalence, distribution and susceptibility pattern of Gram negative bacteria producing ESBLs and Amp C beta lactamases in the largest tertiary health care provider in Kano, North-West Nigeria. A total of 75 ESBL and 10 AmpC producing bacteria were involved in the study which were obtained from a study involving 500 Gram negative clinical bacterial isolates from various hospital wards over a period of 9 months from Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. Isolates were screened for ESBLs and AmpC using Double Disc Diffusion Method and Amp C Disc test respectively. All confirmed ESBL and Amp C producing isolates were tested for susceptibility to sixteen (16) different antibiotics by the Disc Diffusion Method (DDM). The prevalence of ESBLs was high in Shigella spp. (1/2 or 50%), followed by Klebsiella pneumoniae (10/50 or /20%), and E. coli (47/247 or 19.3%) while Amp C producers were detected more in Klebsiella pneumoniae (4%) and E. coli (2.8%). Of the specimens screened, distribution varies between ESBL and AmpC producers, but more prevalent in urinary tract pathogens in both. Highest prevalence of ESBLs and AmpC producers was recorded in intensive care units and surgical wards. ESBL and AmpC production in the hospital is not sex dependent statistically, thought higher in males (52 and 60%) than in females (48 and 40%) for ESBL and AmpC respectively. ESBL and AmpC producers were both sensitive to Imipenem, Nitrofurantoin and Levofloxacin and resistance to Amoxycillin, Ceftazidime and Tetracycline. The study indicates the occurrence of ESBL and AmpC producers in our tertiary health provider, widely distributed in various clinical samples, wards and sexes and are multi drug resistant posing serious threat in managing life threatening infections.

Prevalence of AmpC β-lactamase among Gram-negative bacteria recovered from clinical specimens in Benin City, Nigeria

“…This agrees with the findings of Yusuf et al [27]. Similarly, there was no significant difference (p = 0.5006) in the prevalence of AmpC β-lactamase among isolates recovered from in-patients and out-patients.…”

“…This is not in agreement with the findings of Yusuf et al [27] where isolates from urine were the predominant producers of AmpC β-lactamase. No reason could be adduced for this difference, albeit, the prevalence of AmpC β-lactamase differ significantly among Gram negative bacteria recovered from various clinical specimens (p = 0.0484).…”

“…In both Black et al [13] and Shivanna and Rao [26] study, the prevalence of AmpC β-lactamase were calculated from isolates resistant to cefoxitin while the prevalence of AmpC-positive in this study was calculated from the total isolates used. The prevalence of AmpC β-lactamase observed in this study was higher than that reported in Kano (2 %) [27]. This may indicate that regions within the same country may have different prevalence rates of AmpCpositive isolates, and this may reflect the degree of antibiotic abuse in the different regions of the country as antibiotics use is unregulated in Nigeria.…”

Prevalence of Extended Spectrum β-Lactamase, AmpC β-Lactamase and Metallo-β-Lactamase Among Gram Negative Bacilli Recovered From Clinical Specimens in Benin City, Nigeria

“…This finding agrees with a study in India in which P. aeruginosa ranked the highest among bacterial isolates producing AmpC β-lactamase with 33.3%, but is however in contrast with a Nigerian study which showed E. coli as the highest producer of the enzyme. 20,21 Citrobacter species were the most prevalent producers of MBL (44.4%) and differs from previous studies. A study in Nigeria had shown E. coli (13.0%) and another study in Uganda showed a high prevalence of MBL genes (NDM-1, VIM and IMP) in K. pneumoniae compared with other GNB.…”

Detection of Extended Spectrum Beta-Lactamases Among Gram Negative Bacilli Recovered from Cattle Feces In Benin City, Nigeria

“…In a previous study evaluating rectal swabs of pigs in Nigeria, Salmonella species ranked next to Klebsiella species in ESBL production (Ugwu et al, 2015). The finding is also in contrast to previous studies on human specimens in South, North-West and South-West Nigeria which observed Enterobacter species and Klebsiella species as the most prevalent producers of ESBL (Ogefere et al, 2015;Ogbolu et al, 2011;Yusuf et al, 2013). Salmonella species, which could be either diarrheagenic (non-typhoidal) or septicemic (typhoidal), can under stress, accept genetic materials from other bacteria, notably E. coli in the gastrointestinal tract (Aibinu et al, 2007).…”