Abstract
Little is known about the molecular basis of antibiotic resistance among uropathogens in Southeast Nigeria. The aim of the study was to characterize enterobacterial uropathogens with respect to drug resistance. One hundred (100) enterobacterial uropathogens were studied. Their antibiotic susceptibility patterns were evaluated using disk diffusion, screened, and confirmed phenotypically for the presence of β-lactamases: ESBL, AmpC, carbapenemase, and MBLs. Screen positives were further tested for various β-lactamase genes by PCR. Our isolates showed variable resistance to most drugs tested. Out of the 58 ESBL screen positive E. coli, 35 were confirmed positive with PCR. The predominant ESBL gene was blaTEM while blaSPM was the most prevalent among MBL genes. Forty-six percentage of the screen positive Salmonella isolates coharbored blaTEM + SHV genes. Nine of the 10 ESBL screen positive K. pneumoniae were phenotypically and PCR positive. Three isolates of K. pneumoniae were positive for MBL genes. All the 10 C. freundii were positive for ESBL genes. The study showed high prevalence of drug-resistant genes among the enterobacterial uropathogens. Majority of the uropathogens harbored >1 antibiotic-resistant gene, and the most predominant gene was ESBL (blaTEM) followed by the MBL (SPM) gene.
Highlights
Urinary tract infections (UTIs) are among the commonest human bacterial infections occurring both in the community and hospital settings, in developing countries with a high rate of casualty and financial cost [1, 2]
A total of one hundred (100) enterobacterial uropathogens, E. coli (58), Salmonella (15), K. pneumoniae (14), Citrobacter freundii (10), and Enterobacter aerogenes (3), were isolated and identified from 300 urine specimens collected from patients that present with clinical symptoms of UTI and positive urine culture (≥105 CFU/mL)
Seven out of the 15 ESBL screen positive Salmonella isolates were confirmed by PCR to coharbor blaTEM + blaSHV genes, 3 isolates harboring blaCTX-M2 (n 1), blaGES (n 1) and blaPER gene (n 1)
Summary
Urinary tract infections (UTIs) are among the commonest human bacterial infections occurring both in the community and hospital settings, in developing countries with a high rate of casualty and financial cost [1, 2]. UTIs are caused by a variety of pathogens but mostly by the Enterobacteriaceae [1, 4, 5]. Ough UTI is treatable, it is becoming increasingly difficult to control because of antibiotic resistance, especially in the Enterobacteriaceae family [8]. As a result, these bacterial uropathogens are of public health concern with huge social and economic challenges [1, 8, 9]. Complications in UTIs are on the increase because of the increasing prevalence of β-lactamases producing uropathogens [4]. Accurate identification of the antimicrobial resistance of a pathogen is decisive for Canadian Journal of Infectious Diseases and Medical Microbiology improved diagnosis, judicious antibiotic use, infection control, and epidemiological surveillance [13]
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