Abstract
Background: Extended spectrum beta-lactamases (ESBLs) are enzymes that compromise the efficacy of all beta-lactams and are spread by plasmids. They are of public health importance the world over; however, in Nigeria in general and Uyo in particular, tests for their detection are not routinely done in hospital laboratories despite increase in treatment failures observed for common clinical conditions like urinary tract infection. Objective: To isolate ESBLs producing uropathogens and the plasmid underlying their resistance to antibiotics. Materials and Methods: Three hundred urine specimens (n = 300) were collected from pregnant women attending antenatal clinics at St. Lukes Hospital, Anua, cultured and incubated according to accepted standard. Identification of isolates was done using Microbact 24E (Oxoid, UK) system. The predominant bacterial pathogens were Escherichia coli (42%) followed by Klebsiella pneumonia (21%), Klebsiella oxytoca (12%), Citrobacter spp. (5%), Proteus mirabilis (7%), Enterobacter spp. (12%) and Acinetobacter baumanii (1%). The isolated bacteria were tested for their antibiotic susceptibility using Clinical Laboratory Standard Institute (CLSI) recommended disc diffusion method. A Double Disk Synergy Test (DDST) and Phenotypic Disk Confirmatory Test (PDCT) were performed to determine ESBL production. Chromagar ESBL was also used to test for the presence of ESBL producing isolates. The plasmid content of ESBL producing isolates and their participation in drug resistance were investigated. Results: Of the 80 bacterial isolates causing urinary tract infection in these women, the ESBL producers were found to be 16 (20%). Out of these 16 ESBL producing urogenital isolates Klebsiella pneumonia (8, 50%) was the most prevalent. Others include Escherichia coli (38%), Klebsiella oxytoca (6%) and Enterobacter cloacae (6). Plasmid content of ESBL producing isolates was found to be 87.5%. Conclusion: The Extended Spectrum Beta-lactamase producing uropathogens mainly of plasmid origin are increasingly responsible for the cause of community acquired urinary tract infections in pregnant women in Uyo.
Highlights
Urinary tract infection is defined as multi-action of organisms in the urinary tract with the presence of >105 organisms per milliliter in mid-stream urine [1]
Extended spectrum Beta-lactamases (ESBls) are enzymes that compromise the efficacy of all beta-lactams, except Cephamycins and Carbapenems by hydrolysis of beta-lactam ring and are inhibited by beta-lactam inhibitors [7]
The antibiotic discs were from OXIOD England, and the various methods of Extended spectrum beta-lactamases (ESBLs) detection used were for comparison and quality control
Summary
Urinary tract infection is defined as multi-action of organisms in the urinary tract with the presence of >105 organisms per milliliter in mid-stream urine [1]. Extended spectrum beta-lactamases (ESBLs) are enzymes that compromise the efficacy of all beta-lactams and are spread by plasmids They are of public health importance the world over; in Nigeria in general and Uyo in particular, tests for their detection are not routinely done in hospital laboratories despite increase in treatment failures observed for common clinical conditions like urinary tract infection. Results: Of the 80 bacterial isolates causing urinary tract infection in these women, the ESBL producers were found to be 16 (20%). Out of these 16 ESBL producing urogenital isolates Klebsiella pneumonia (8, 50%) was the most prevalent.
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