Prevalence and multidrug resistance of Escherichia coli from community-acquired infections in Lagos, Nigeria

Abstract

Introduction: The emergence of multidrug resistance (MDR; resistance to ≥ 2 more antimicrobials) in Escherichia coli is of concern due to complications encountered in treatment. Methodology: In this study, prevalence, antimicrobial resistance, and genetic characteristics of MDR community isolates of E. coli from Lagos, Nigeria were determined. Urine and stool samples were obtained from outpatients attending Lagos State hospitals and from animal handlers in abattoirs, poultries, and open markets, from December 2012 to July 2013.Results: Approximately 50% of urine (200/394) and 88% of stool samples (120/136) were positive for E. coli. Based upon β-lactamase production, a subset of those isolates was selected for further study. Of the 22 antimicrobials tested, E. coli exhibited resistance to all antimicrobials except amikacin and piperacillin/tazobactam. The highest levels of resistance were to tetracycline (182/247; 73.7%), trimethoprim/sulfamethoxazole (152/247; 61.5%), and ampicillin (147/247; 59.1%). Resistance to the cephalosporins ranged from 1.6%-15% including the third-and fourth-generation cephalosporins, cefpodoxime (20/247; 8.1%) and cefepime (4/247; 1.6%), respectively. MDR was observed in 69.6% (172/247) of the isolates. Forty-eight E. coli resistant to at least five antimicrobials were selected for further analysis using pulsed-field gel electrophoresis; seven distinct clusters were observed among the diverse patterns. Of the 48 MDR E. coli, 30 different sequence types (ST) were detected using multilocus sequence typing, including four ST131. Conclusions: This study demonstrated circulating MDR E. coli in the Nigerian community. Monitoring of antimicrobial resistance in developing countries is necessary to optimize empiric treatment and the prudent use of antimicrobials.

Draft Genome Sequence Analysis of Multidrug-Resistant Escherichia coli Strains Isolated in 2013 from Humans and Chickens in Nigeria

“…All isolates had at least one extended-spectrum β-lactamase (ESBL) resistance gene detected. The isolates also harbored genes conferring resistance to aminoglycosides, tetracycline, trimethoprim, sulfonamides, fluoroquinolones, and chloramphenicol, consistent with their reported phenotypes ( 15 , 16 ). The detection of circulating antibiotic resistance genes in bacteria from humans and food animals using genome sequencing is useful in predicting emerging resistance, especially in underfunded countries.…”

“…In order to effectively treat these infections, it is important to understand the mechanisms of resistance in E. coli . As a first step in this study, we report here the draft genome sequences of nine MDR E. coli strains isolated from outpatients ( n = 5), animal handlers ( n = 1), and chickens ( n = 3) in Lagos, Nigeria, in 2013 ( 15 , 16 ).…”

The population structure of clinical extra-intestinal Escherichia coli in a teaching hospital from Nigeria

“…This may be explained by either variation in the occurrence of ESBLs across regions/states or the rising trend of ESBLs in Nigeria. This study and other studies from Nigeria are showing low levels of resistance of E. coli to piperacillin-tazobactam and carbapenems (Adenipekun et al, 2016, Iliyasu et al, 2016, underscoring the need to strengthen antimicrobial stewardship programs to preserve them as potential therapeutic options now and for future generations.…”

“…There is an need to evaluate simple, reliable and cost effective epidemiological laboratory tools in resource limited countries such as those in Africa, where limited information exist regarding the population structure of ExPEC. Previous studies from Lagos and Oyo states in Nigeria have revealed presence of E. coli ST131, but did not determine the presence of other clones among ExPEC (Adenipekun et al, 2016, Aibinu et al, 2012, Inwezerua et al, 2014. A study was designed to determine antimicrobial susceptibility patterns and the population structure of ExPEC isolates (ST/fimH types) in a tertiary care center from North-eastern Nigeria.…”

Aeromonas hydrophilafrom marketed mullet (Mugil cephalus) in Egypt: PCR characterization ofβ-lactam resistance and virulence genes

“…Antimicrobial resistance is mostly attributed to the misuse of antimicrobial drugs as therapies, prophylactics and as growth promoters (Frye and Jackson 2013;Adenipekun et al 2016). Data available thus far has indicated that expression of antimicrobial resistance occurs either due to chromosomal mutations or after acquisition of resistance genes carried on mobile genetic elements, mostly plasmids (Blair et al 2015;Stratev and Odeyemi 2016).…”