Abstract
Owing to the increasing epidemiological and therapeutic challenges associated with infections due to ESBL producers, ESBL prevalence rate among some bacteria isolates from healthy and non-healthy human population in a metropolitan Nigerian setting was evaluated. A total of one hundred and forty-five (145) bacteria strains were isolated from a total of four hundred and sixty (460) samples collected from urine, wound, throat and anal swabs of 220 healthy volunteers in the community and from 240 patients in 2 secondary and 2 tertiary hospitals (altogether, 4) in Enugu metropolis. The presumptive confirmatory test used for ESBL detection was the Double Disc Synergy Test (DDST) method. Conjugation and plasmid curing studies were also done for resistance factor determination. Of the 145 isolates, 20 were ESBL producers with 35% of these ESBL producers being of community origin and 65% from hospitals. This translates to 4.8% and 9% incidences (comparably higher than established prevalence of 4.4% and 7.5 respectively) for community and hospital infections respectively. The ESBL isolates showed high resistance to tetracycline, gentamicin, pefloxacin, ceftriaxone, cefuroxime, ciprofloxacin and Augmentin(®) (Amoxicilin and clavulanic acid combination). Conjugation studies for Resistance plasmid transfer showed non-transference of resistance determinants between the ESBL transconjugants and recipient strains. Correspondingly, the plasmid curing studies revealed that the acridine orange could not effect a cure on the isolates as they still retained high resistance to the antibiotics after the treatment. This study confirms the growing incidences/pool of ESBL strains in Nigeria and call for widespread and continuous monitoring towards an effective management of the potential therapeutic hurdle posed by this trend.
Highlights
The introduction of third- and fourth-generation cephalosporins as therapeutic agents has been followed by the dissemination of different extended-spectrum b-lactamases (ESBLs) that hydrolyse those b-lactam drugs and monobactam antibiotics
This study confirms the growing incidences/pool of ESBL strains in Nigeria and call for widespread and continuous monitoring towards an effective management of the potential therapeutic hurdle posed by this trend
ESBL positive isolates of Klebsiella pneumoniae, Klebsiella oxytoca, Escherichia coli and Pseudomonas aeruginosa were mated with an Escherichia coli recipient strain that is rifampicin resistant and susceptible to Antibiotic Resistant Markers (ARM) that will include gentamicin, ampicillin, tetracycline, chloramphenicol and trimethoprim/sulphamethoxazole
Summary
The introduction of third- and fourth-generation cephalosporins as therapeutic agents has been followed by the dissemination of different extended-spectrum b-lactamases (ESBLs) that hydrolyse those b-lactam drugs and monobactam antibiotics. SPECTRUM BETA LACTAMASE PRODUCERS ISOLATED FROM A MIXED HUMAN POPULATION clinical isolates from specific localities within the Western and Eastern part of the country have been reported [ ] These initial preliminary reports have further heightened the necessity of extending similar studies to cover more unsampled localities, to further harmonize the epidemiological data base, and the need for a continuous epidemiological monitoring of the prevalence rate of these ESBL bacteria isolates. Data generated from such foregoing exercises would define the existent bacteria resistance indices and clearly serve as a useful baseline in determining the rational and effective chemotherapeutic options for the management of infectious disease due to the ESBL bacteria organisms. It is based on these established premises that this present study was carried out to determine the prevalence rate of these pathogenic ESBL-producing enterobacteriaceae organisms in the sampled community
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