Prevalence of antibiotic-resistant gram-negative bacteria among patients with urinary tract infection at a facility in Ado Ekiti, Ekiti-State, Nigeria

Abstract

Urinary Tract Infections (UTIs) constitute a huge public health burden especially in developing countries. This study was carried out to determine the current incidence of antibiotic resistance among Gram-negative bacteria recovered from urine of patients with UTI. This study used a cohort study design wherein one hundred and twenty one (121) mid-stream urine samples were collected and cultured onto sterile Cysteine Lactose Electrolyte Deficient medium (CLED) and MacConkey agar plates. All bacteria recovered were tested for resistance to the selected antibiotics as follows: ceftazidime (30 μg), ceftriaxone (30 μg), gentamicin (1 0μg), ampicillin (10 μg), meropenem (10 μg), ertapenem (10 μg), tetracycline (30 μg), norfloxacin (10 μg) and pefloxacin (5 μg). Twenty (20) isolates were chosen for detection of extended spectrum beta-lactamase producers using the double disk synergy test (DDST). All the bacteria were tested for biofilm production and haemolysis. Among the one hundred and twenty-one (121) mid-stream urine samples collected from patients, forty-six (46) samples grew significant bacteria. The bacteria recovered were Klebsiella pneumonia17 (37.0%), Klebsiella oxytoca 2 (4.3%), Escherichia coli (32.6%) and Proteus mirabilis (26.0%). Overall, the bacteria showed the highest resistance to pefloxacin (97.8%) and least resistance to meropenem (34.7%). The bacteria also showed high multiple resistance. All the bacteria subjected to DDST were confirmed as extended-spectrum beta-lactamase ESBL producers. Forty (43.6%) bacteria were designated as strong biofilm producers while 17.4 % bacteria showed hemolysis. The findings obtained in this study have ramifications for clinical management of UTI and public health public health in general. There should be strict enforcement of antibiotic stewardship.