Abstract
Objective: Infections of the urinary tract remains one of the most common bacterial infections with many implicated organisms being Gram-negative, which are increasingly resistant to antimicrobial agents. The aim of the study was to evaluate the resistance of ESBL producing Gram-negative enterobacteriaceae to commonly prescribed antibiotics and the prevalence of CTX-M genes from these isolates using polymerase chain reaction (PCR).
 Methods: The isolates were collected from urine over a period of 4 mo and studied, and were identified using Microgen Identification Kit (GN-ID). Susceptibility testing was performed by the modified Kirby Bauer disc diffusion method, and results were interpreted according to Clinical and Laboratory Standard Institute (CLSI). Extended-Spectrum Beta-Lactamase (ESBL) production was detected by the double-disc synergy test (DDST). Molecular characterization was based on the isolates that were positive for the phenotypic detection of ESBL.
 Results: Sixty one (61) isolates of Gram-negative uropathogens were identified. Of these, 19 (31.2%) were E. coli, 15 (24.6%) were Salmonella arizonae, Klebsiella pneumoniae were 7 (11.5%), Klebsiella oxytoca were 3 (4.9%), Enterobacter gergoviae were 6 (9.8%), 4 (6.6%) were Citrobacter freundii, 4 (6.6%) were Serratia marscence, and 1 (1.6%) were Enterobacter aerogenes, Proteus mirabilis, and Edwardsiella tarda each. Analysis of the bacterial susceptibility to antibiotics revealed most of them to be generally resistant to cotrimoxazole (73.3%), nalidixic acid (66.7%), norfloxacin (53.5%), ciprofloxacin (50.5%), gentamicin (48.6%), amoxicillin/clavulanate (45%), and the least resistant was displayed in nitrofurantoin (30%). Of the 15 ESBL producers, 11 (73.3%) were harbouring bla CTX-M genes.
 Conclusion: The study revealed a high susceptibility to nitrofurantoin, whereas susceptibility to cotrimoxazole was lowest. It further portrays a high prevalence of enterobacteriaceae isolates harbouring bla CTX-M genes in Sokoto metropolis.
Highlights
Urinary Tract Infections (UTIs) are a serious public health issue, in the developing world where there is a high level of poverty, ignorance and poor hygienic practices [1]
The results showed that the percentage of Gram-negative isolates was 16.7%
The Gram-negative isolates consist mainly of E. coli (31.1%), Salmonella arizonae 24.6%, Klebsiella oxytoca 4.9%, Klebsiella pneumoniae 11.5%, Enterobacter gergoviae 9.8%, Citrobacter freundii 6.6%, Serratia marscence 6.6%, and 1.6% were Enterobacter aerogenes, Proteus mirabilis, and Edwardsiella tarda each
Summary
Urinary Tract Infections (UTIs) are a serious public health issue, in the developing world where there is a high level of poverty, ignorance and poor hygienic practices [1]. The constant increase of simultaneous resistance to various classes of antibiotics significantly reduces the possibility of treatment of infections caused by ESBL producers [5,6,7] have reported that the management of UTIs has become increasingly challenging due to the production of ESBLs. The constant increase of simultaneous resistance to various classes of antibiotics significantly reduces the possibility of treatment of infections caused by ESBL producers [5,6,7] have reported that the management of UTIs has become increasingly challenging due to the production of ESBLs They tend to be a worrying global public health issue due to their associated higher morbidity and mortality. They represent a clear and present higher danger to public health [8]
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