Antimicrobial Resistance Profile and Extended Spectrum Beta-lactamase Resistance Genes in Escherichia coli from Patients in General Hospital, Karshi, Abuja, Nigeria

Bassey A.P *

Laboratory Department, Nigerian National Petroleum Corporation Medical Services, Abuja, Nigeria.

Ngwai Y.B

Department of Microbiology, Nasarawa State University, Keffi, Nigeria.

Nkene I.H

Department of Microbiology, Nasarawa State University, Keffi, Nigeria.

Tama S.C

Department of Microbiology, Nasarawa State University, Keffi, Nigeria.

Igbawua I.N

Department of Microbiology, Nasarawa State University, Keffi, Nigeria.

Bassey B.E

World Health Organization (WHO) Nigeria Country Office, UN House, Plot 617/618, Diplomatic Drive, Central Business District, PMB 2861, Garki, Abuja, Nigeria.

*Author to whom correspondence should be addressed.


Abstract

Aims: This study investigated the antimicrobial resistance profile and extended spectrum beta-lactamase resistance genes in Escherichia coli of from urine of patients sourced from General Hospital, Karshi, Abuja, Nigeria.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Microbiology, Nasarawa State University, Keffi, between August 2022 and February 2023.

Methodology: A total of 120 samples were collected from patients. Escherichia coli was isolated from the samples using standard microbiological methods. Antibiotic susceptibility testing was evaluated as described by the Clinical and Laboratory Standards Institute (CLSI). The detection of ESBL production in E. coli isolates was carried out using double disc synergy test.  In addition, molecular detection of ESBL genes was carried out using Polymerase Chain Reaction (PCR) method.

Results: The prevalence of E. coli was 17.5% (21/120), out of which two (2) of the positive isolates (9.5%) were male, and 19 (90.5%) female. Antibiotic resistances in the isolates in decreasing order were as follows: sulphamethoxazole / trimethoprim (SXT: 81.0%), amoxicillin/clavulanic acid (AMC: 61.9%), ofloxacin (OFX: 66.7%), cefotaxime (CTX: 53.4%), gentamicin (CN: 42.9%), ceftriaxone (CRO: 33.3%), imipenem (IPM: 33.3%), meropenem (MOR: 42.4%), nitrofurantoin (NET: 20.3%) and ciprofloxacin (CIP: 23.8%). The commonest antibiotic resistant resistance phenotype was CIP-OFX-SXT (23.8%). Multiple antibiotic resistance (MAR) was observed in 90.5% (19/21) of the isolates, with the common MAR index being 0.3 (23.8%). Six of the twenty one beta-lactam resistant isolates (28.5%) were confirmed ESBL producers. The 6 ESBL positive isolates carried bla genes as follows: blaTEM (1/6, 16.7%) and blaCTX-M (1/6, 16.7%). blaSHV only was not found in any of the isolates.

Conclusion: The E. coli isolates from urine of patients in General Hospital, Karshi, Abuja, Nigeria was less resistant to ciprofloxacin, nitrofurantoin, meropenem and imipenem. This implies that the antibiotics are useful in the treatment of infection caused by E. coli. Also, ESBL-positive E. coli isolates harbored ESBL genes, with blaCTX-M and blaTEM as the most common.

Keywords: Escherichia coli, urine, antibiotic, resistance, ESBL, genes


How to Cite

Bassey A.P, Ngwai Y.B, Nkene I.H, Tama S.C, Igbawua I.N, & Bassey B.E. (2024). Antimicrobial Resistance Profile and Extended Spectrum Beta-lactamase Resistance Genes in Escherichia coli from Patients in General Hospital, Karshi, Abuja, Nigeria. Asian Journal of Biochemistry, Genetics and Molecular Biology, 16(5), 10–20. https://doi.org/10.9734/ajbgmb/2024/v16i5373

Downloads

Download data is not yet available.

References

Murugan K, Savitha T, Vasanthi S. Retrospective study of antibiotic resistance among uropathogens from rural teaching hospital, Tamilnadu, India. Asian Pacific Journal of Tropical Disease. 2012 Oct 1;2(5):375-80.

Chakupurakal R, Ahmed M, Sobithadevi DN, Chinnappan S, Reynolds T. Urinary tract pathogens and resistance pattern. Journal of Clinical Pathology. 2010 Jul 1;63(7):652-4.

Karlowsky JA, Lagacé-Wiens PR, Simner PJ, DeCorby MR, Adam HJ, Walkty A, Hoban DJ, Zhanel GG. Antimicrobial resistance in urinary tract pathogens in Canada from 2007 to 2009: CANWARD surveillance study. Antimicrobial Agents and Chemotherapy. 2011 Jul;55(7):3169-75.

Baral P, Neupane S, Marasini BP, Ghimire KR, Lekhak B, Shrestha B. High prevalence of multidrug resistance in bacterial uropathogens from Kathmandu, Nepal. BMC Research Notes. 2012 Dec; 5(1):1-9.

Mukherjee K, Tribedi P, Mukhopadhyay B, Sil AK. Antibacterial activity of long-chain fatty alcohols against mycobacteria. FEMS Microbiology Letters. 2013 Jan 1;338(2): 177-83.

Khanna N, Boyes J, Lansdell PM, Hamouda A, Amyes SG. Molecular epidemiology and antimicrobial resistance pattern of extended-spectrum-β-lactamase-producing Enterobacteriaceae in glasgow, scotland. Journal of Antimicrobial Chemotherapy. 2012 Mar 1;67(3):573-7.

Vaidya VK. Horizontal transfer of antimicrobial resistance by extended-spectrum β lactamase-producing Enterobacteriaceae. Journal of Laboratory Physicians. 2011 Jan;3(01):037-42.

Ajobiewe HF. Parasitological and fungal assessment of fresh cow milk obtained from five herds in Karshi, FCT Nigeria. SAS J Med. 2021 Sep;9:395-406.

Cheesbrough M. District laboratory practice in tropical countries. Cambridge University Press; 2006.

Bergey’s manual of determinative bacteriology. Identification flow charts; 2019.

Available:http://mysite.science.uottawa.ca/jbasso/microlab/IDFlowcharts.pdf Accessed on November 2019.

Clsi C. Performance standards for antimicrobial susceptibility testing: 25th informational supplement. CLSI document M100-S25. Clinical and Laboratory Standards Institute; 2015.

Giriyapur RS, Nandihal NW, Krishna BVS, Patil AB, Chandrasekhar MR. Comparison of disc diffusion methods for the detection of extended-spectrum Beta lactamase-producing Enterobacteriaceae. Journal of Laboratory Physicians. 2011;3(1):33.

Abimiku RH, Ngwai YB, Nkene IH, Tatfeng YM. Molecular detection of diarrheagenic pathotypes of Escherichia coli from diarrheic patients in Keffi, Nigeria. Microbioz Journals, Journal of Microbiology and Biomedical Research. 2016;2(3):1-6.

Tama SC, Ngwai YB, Nkene IH, Abimiku RH. Molecular detection of extended spectrum beta-lactamase resistance in Escherichia coli from poultry droppings in Keffi, Nigeria. Asian Journal of Medicine and Health. 2019;1-9.

Porteous LA, Armstrong JL, Seidler RJ, Watrud LS. An effective method to extract DNA from environmental samples for polymerase chain reaction amplification and DNA fingerprint analysis. Current Microbiology. 1994;29(5):301-307.

Gajdács M, Ábrók M, Lázár A, Burián K. Increasing relevance of gram-positive cocci in urinary tract infections: A 10-year analysis of their prevalence and resistance trends. Scientific Reports. 2020 Oct 19;10(1):17658.

Nkene IH, Ngwai YB, Omede MU, Samuel J, Envuladu EY, Abimiku RH. Extended spectrum beta-lactamase producing Escherichia coli from urine of symptomatic and asymptomatic subjects in Keffi, Nigeria. International Journal of Research Studies in Biosciences. 2015;3(12):1-5.

Bassey A, Ngwai YB, Bassey BE, Nkene IH, Abimiku RH, Parom SK. Phenotypic and molecular detection of extended spectrum β-lactamase in Escherichia coli from patients in Nigerian National Petroleum Corporation Medical Services, Abuja, Nigeria. Annual Research & Review in Biology. 2018 Sep 7;1-7.

Ekeng BE, Ochang EA, Elem DE, Owai PA, Monjol BE, Ukweh IH, Nwagboso CI, Abraka BA, Ereh SE. Antibiotic resistance pattern of uropathogens in a tertiary care hospital in calabar, Nigeria. Annual Research & Review in Biology. 2021 Jun 15;36(6):10-8.

Farooq M, Gul A, Mahmood A, Anwar M, Mir TS, Altaf A. Extended-spectrum beta-lactamase (ESBL) producing, multidrug-resistant (MDR) uropathogens and their antimicrobial susceptibility profile: A tertiary care hospital experience. Pakistan Armed Forces Medical Journal. 2022 Feb 28;72(1):20-4.

Amadu DO, Nwabuisi C, Yunusa T, Nasir IA, Oladejo JM, Seibu E, Fadeyi A, Usman Y, Aliyu D. Prevalence and associated factors associated with Uropathogenic Escherichia coli isolates from catheterized persons at Ilorin Tertiary Hospital, Nigeria. Afro-Egyptian Journal of Infectious and Endemic Diseases. 2019 Jun 1;9(2):119-28.

Shitu S, Gambo BA, Musa MO, Abubakar AA, Attahiru M. Prevalence of multidrug resistant Escherichia coli In suspected cases of urinary tract infection among patients attending ahmadu bello university medical center, Zaria. UMYU Journal of Microbiology Research (UJMR). 2020 Dec 30;5(2):123-30.

Foxman B. Urinary tract infection syndromes: Occurrence, recurrence, bacteriology, risk factors, and disease burden. Infectious Disease Clinics. 2014 Mar 1;28(1):1-3.

Medugu N, Aworh MK, Iregbu K, Nwajiobi-Princewill P, Abdulraheem K, Hull DM, Harden L, Singh P, Obaro S, Egwuenu A, Thakur S. Molecular characterization of multi drug resistant Escherichia coli isolates at a tertiary hospital in Abuja, Nigeria. Scientific reports. 2022 Sep 1;12(1):14822.

Murray BE. Resistance of Shigella, Salmonella, and other selected enteric pathogens to antimicrobial agents. Reviews of Infectious Diseases. 1986 May 1;8(Supplement_2):S172-81.

Demir M, Kazanasmaz H. Uropathogens and antibiotic resistance in the community and hospital-induced urinary tract infected children. Journal of Global Antimicrobial Resistance. 2020 Mar 1;20:68-73.

Kot B, Grużewska A, Szweda P, Wicha J, Parulska U. Antibiotic resistance of uropathogens isolated from patients hospitalized in district hospital in central Poland in 2020. Antibiotics. 2021 Apr 16;10(4):447.

Saeed CH, AL-Otraqchi KI, Mansoor IY. Prevalence of urinary tract infections and antibiotics susceptibility pattern among infants and young children in Erbil city. Zanco Journal of Medical Sciences (Zanco J Med Sci). 2015 Apr 1;19(1):915_922-.

Alkhateeb NE. Antibiotic resistance of urinary tract pathogens and rationale for empirical antibiotic therapy in children with urinary tract infection. Zanco Journal of Medical Sciences (Zanco J Med Sci). 2016 Dec 15;20(3):1458_1466-.

Hussein NH. Prevalence and antimicrobial susceptibility patterns of bacteria isolated from urinary tract infections (UTIs) in children at children hospital in Baghdad. Al-Kindy College Medical Journal. 2017; 13(1):102-7.

Assafi MS, Ibrahim NM, Hussein NR, Taha AA, Balatay AA. Urinary bacterial profile and antibiotic susceptibility pattern among patients with urinary tract infection in duhok city, kurdistan region, Iraq. International Journal of Pure and Applied Sciences and Technology. 2015 Oct 1;30(2):54.

Aka ST, Haji SH. Evaluation of multi drug resistance among extended spectrum β-lactamase-producing Escherichia coli causing urinary tract infection in Erbil City. Zanco Journal of Medical Sciences (Zanco J Med Sci). 2015 Aug 16;19(2):998-1004.

Alqasim A, Abu Jaffal A, Alyousef AA. Prevalence of multidrug resistance and extended-spectrum β-lactamase carriage of clinical uropathogenic Escherichia coli isolates in Riyadh, Saudi Arabia. International Journal of Microbiology. 2018 Sep 16;2018.

Adamu AA, Gadanya MA, Jalo RI, Uthman OA, Wiysonge CS. Factors influencing non-prescription sales of antibiotics among patent and proprietary medicine vendors in Kano, Nigeria: A cross-sectional study. Health Policy and Planning. 2020 Aug;35(7):819-28.

Agegnehu A, Worku M, Nigussie D, Lulu B, Tadesse BT. Pediatric febrile urinary tract infection caused by ESBL producing Enterobacteriaceae species. BioMed research international. 2020 Dec 2;2020:1-8.

Calbo E, Romaní V, Xercavins M, Gómez L, Vidal CG, Quintana S, Vila J, Garau J. Risk factors for community-onset urinary tract infections due to Escherichia coli harbouring extended-spectrum β-lactamases. Journal of Antimicrobial Chemotherapy. 2006 Apr 1;57(4):780-3.

Awean GZ, Salameh K, Elmohamed H, Alshmayt H, Omer MR. Prevalence of ESBL urinary tract infection in children. J Adv Pediatr Child Health. 2019;2(1):004-7.

Rezai MS, Salehifar E, Rafiei A, Langaee T, Rafati M, Shafahi K, Eslami G. Characterization of multidrug resistant extended-spectrum beta-lactamase-producing Escherichia coli among uropathogens of pediatrics in North of Iran. BioMed Research International. 2015 May 3;2015.

Kizilca O, Siraneci R, Yilmaz A, Hatipoglu N, Ozturk E, Kiyak A, Ozkok D. Risk factors for community‐acquired urinary tract infection caused by ESBL‐producing bacteria in children. Pediatrics International. 2012 Dec;54(6):858-62.

Kaarme J, Riedel H, Schaal W, Yin H, Nevéus T, Melhus Å. Rapid increase in carriage rates of Enterobacteriaceae producing extended-spectrum β-lactamases in healthy preschool children, Sweden. Emerging Infectious Diseases. 2018 Oct;24(10):1874.

Rodríguez-Bano J, Navarro MD, Romero L, Martínez-Martínez L, Muniain MA, Perea EJ, Pérez-Cano R, Pascual A. Epidemiology and clinical features of infections caused by extended-spectrum beta-lactamase-producing Escherichia coli in nonhospitalized patients. Journal of Clinical Microbiology. 2004 Mar;42(3): 1089-94.