Klebsiella pneumoniae (K. pneumoniae) is an opportunistic bacteria responsible for many nosocomial and community-acquired infections. The emergence and spread of antibiotic resistances have resulted in widespread epidemics and endemic dissemination of multidrug-resistant pathogens. A total of 145 K. pneumoniae isolates were recovered from hospital wastewater effluents and subjected to antibiogram profiling. Furthermore, the antibiotic resistance determinants were assessed among phenotypic resistant isolates using polymerase chain reaction (PCR). The isolates showed a wide range of antibiotic resistance against 21 selected antibiotics under 11 classes, with the most susceptible shown against imipenem (94.5%) and the most resistant shown against ampicillin (86.2%). The isolates also showed susceptibility to piperacillin/tazobactam (89.0%), ertapenem (87.6%), norfloxacin (86.2%), cefoxitin (86.2%), meropenem (76.6%), doripenem (76.6%), gentamicin (76.6%), chloramphenicol (73.1%), nitrofurantoin (71.7%), ciprofloxacin (79.3%), amikacin (60.7%), and amoxicillin/clavulanic acid (70.4%). Conversely, resistance was also recorded against tetracycline (69%), doxycycline (56.6%), cefuroxime (46.2%), cefotaxime (48.3%), ceftazidime (41.4%). Out of the 32 resistance genes tested, 28 were confirmed, with [tetA (58.8%), tetD (47.89%), tetM (25.2%), tetB (5.9%)], [sul1 (68.4%), sul1I (66.6%)], and [aadA (62.3%), strA (26%), aac(3)-IIa(aacC2)a (14.4%)] genes having the highest occurrence. Strong significant associations exist among the resistance determinants screened. About 82.7% of the K. pneumoniae isolates were multidrug-resistant (MDR) with a multiple antibiotics resistance index (MARI) range of 0.24 to 1.0. A dual presence of the resistant genes among K. pneumoniae was also observed to occur more frequently than multiple presences. This study reveals a worrisome presence of multidrug-resistant K. pneumoniae isolates and resistance genes in hospital waste effluent, resulting in higher public health risks using untreated surface water for human consumption. As a result, adequate water treatment and monitoring initiatives designed to monitor antimicrobial resistance patterns in the aquatic ecosystem are required.
Introduction and objective. The study was carried out to determine the occurrence and antibiotics susceptibility profile of Escherichia coli recovered from patients with urinary tract infection (UTI) in Nsukka, southeastern Nigeria. Materials and method. Midstream urine samples were obtained from 266 outpatients. Standardized questionnaires were used to collect relevant information from the subjects. Urine samples were plated on MacConkey and eosin methylene blue agar. E. coli isolates were identified using standardized procedure. Kirby-Bauer disc diffusion method was used to determine the susceptibility of the isolates. Results. An overall UTI prevalence of 18.8% with 29 (19.30%) from females and 21 (18.10%) from males was observed. Females and males within the age range of 20-29 and 50-59 had the highest prevalence rate of 23.2% and 15%, respectively. The highest prevalence rate (26%) occurred in the Igbo-Etiti local government area, compared to the other four local government areas within the study locations. Urinalysis showed that 16 urine samples contained protein, 29 were nitrite positive and 31 were acidic. Most of the isolates were susceptible to nitrofurantoin (94%), ciprofloxacin (70%) and ofloxacin (78%) while all of them were completely resistant to cefuroxime, ceftazidime and augmentin (100%). All 50 (100%)E. coli isolates showed multiple resistance to three or more antibiotics with a resistance index ranging from 0.375-1.00. The MIC results showed that 17 (34%) isolates were sensitive to gentamicin (MIC ≤ 0.25µg/ml, MBC ≥ 128µg/ml), resistant to ciprofloxacin and ofloxacin. Conclusion. E. coli is predominantly associated with UTI in the study area and was susceptible to nitrofurantoin.
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