High level detection of extended spectrum beta-lactamase gene encoding Enterobacteriaceae in public toilets in Abeokuta, Nigeria

S.A Balogun,O.E Ojo,S.O Kareem,O.O Bayode

doi:10.4038/cjs.v49i2.7737

Abstract

Increasing reports of the pandemic nature of extended spectrum β-lactamase (ESBL) producing bacteria in clinical infections called for more surveillance to identify possible sources of infection. This study examined the dissemination of ESBL producing Enterobacteriaceae in hospital and public toilet facilities in Abeokuta. Swab samples were collected from toilet seats, door handles, toilet bowls and flush handles. Detection of ESBL producing isolates was done using double disc test. Presence of ESBL gene was done using multiplex PCR. Overall, ESBL-producing bacteria was detected in 44 (27.5%) out of 160 samples. ESBL-producing bacteria were detected at significantly higher rate )p<0.001) in hospital toilets than in community toilets. Isolates were identified as Klebsiella pneumoniae (n=25), Klebsiella oxytoca (n=2), Citrobacter freundii (n=6), Citrobacter youngae (n=3), Escherichia coli (n=5), Enterobacter cloacae (n=2) and Enterobacter kobei (n=1). . Analysis for the presence of ESBL gene showed that all the isolates harboured the blaCTX-M- gene while blaTEM and blaSHV were detected in six and two isolates respectively. All the ESBL-producing isolates demonstrated resistance to at least three different classes of antimicrobials. The study showed that public toilets could serve as sources for nosocomial and community transmission of ESBL-producing bacteria in the environment.

Highlights

The extended spectrum β-lactamases (ESBLs) are enzymes capable of hydrolyzing and inactivating beta lactams antimicrobials especially penicillins, monobactams as well as first to fourth generation cephalosporins (Bradford, 2001)
ESBL-producing bacteria constitute an important group of antimicrobial resistant bacteria with significant challenge to infection management in the healthcare sector
ESBL-producing bacteria were detected in high frequency in public toilets within hospital and community settings

Summary

Introduction

The extended spectrum β-lactamases (ESBLs) are enzymes capable of hydrolyzing and inactivating beta lactams antimicrobials especially penicillins, monobactams as well as first to fourth generation cephalosporins (Bradford, 2001). Bacteria that produce ESBLs are resistant to many clinically important old and new generation penicillins and cephalosporins (Bradford, 2001). The β-lactam antimicrobials are among the most commonly used antimicrobials in human medicine because of their relatively high efficacy, low toxicity and low cost (Bush and Bradford, 2016). The Enterobacteriaceae are widely distributed in nature and are the most commonly isolated bacteria strains in clinical samples. They are associated with hospital- and community-acquired extra-intestinal infections including septicaemia, meningitis and urogenital tract diseases (Vading et al, 2018)

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