Abstract
BackgroundThe aim of this study was to determine the occurrence and production of Extended-Spectrum Beta-Lactamases (ESBLs) and Metallo Beta-Lactamases (MBLs) in P. aeruginosa isolated from HIV-infected patients from a hospital in Ibadan, Nigeria using currently available phenotypic tests and real-time PCR of selected reference genes. MethodsThis was a cross sectional study and samples were aseptically collected from consenting HIV infected patients between April and May 2018 at a tertiary hospital in Ibadan, Nigeria. Pseudomonas species were isolated from stool samples using Pseudomonas Base Agar and were identified by standard protocol. Phenotypic detection of ESBL and MBL was carried out using the disk potentiation test. Antibiotics susceptibility testing was done using Kirby-Bauer disk diffusion technique against ceftazidime and cefepime, amoxicillin-clavulanate, aztreonam, trimethoprim, gentamicin, ciprofloxacin and imipenem. Using Real-Time PCR, ESBL and beta-lactamase encoding genes such as blaTEM, blaSHV, AmpC, blaCTX and blaKPC in the ESBL-producing Pseudomonas aeruginosa isolated from the HIV-infected patients stool samples. Data were analyzed using descriptive statistics and chi-square test. ResultsThe Pseudomonas species comprised 95.3% P. aeruginosa and 4.7% P. fluorescens, of which 29.1% produced ESBL, but none produced MBL. All ESBL-producers showed resistance to trimethoprim and ciprofloxacin while, 20.0% were resistant to aztreonam, but none resist imipenem. In the ESBL-producing isolates, AmpC and blaTEM genes were detected while, blaSHV, blaCTX and blaKPC genes were not detected. ConclusionThe ESBL-production was only detected in Pseudomonas aeruginosa isolates out of which only AmpC and blaTEM genes were detected. The ESBL and ESBL genes detection in the Pseudomonas aeruginosa and multidrug-resistant strains portend public health threat among the studied patients. Hence, it is recommended that indiscriminate use of antibiotics among people living with HIV should be discouraged. Secondly, because of the AmpC significance in the provision of high levels of beta-lactams antibiotic resistance, especially the third generation cephalosporins commonly used for treatments, further research is hereby recommended.
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