Isolation, Phenotypic Characterization and Prevalence of ESBL-Producing Escherichia Coli and Klebsiella Species from Orthopedic Wounds in National Orthopedic Hospital Enugu (NOHE), South East Nigeria

Abstract

The objective of this research work was to isolate, characterize and determine the prevalence of ExtendedSpectrum β-Lactamase (ESBL)-producing E. coli and Klebsiella spp. from orthopedic wounds of patients admitted at National Orthopedic Hospital Enugu (NOHE), South East Nigeria. In this study, 171 bacterial isolates were obtained from 257 orthopedic wound swabs over a period of one year. Sixty nine (69) of the bacterial isolates were identified as E. coli while 102 were Klebsiella spp based on standard microbiological techniques. The phenotypic screening of the 171 bacterial isolates (E. coli and Klebsiella spp) for ESBL production was done by disc diffusion method using second and third generation cephalosporins. The ESBL producers were confirmed using double disc synergy test. Susceptibility of the ESBL-producing bacterial isolates to antibiotics was done on Mueller-Hinton agar by Kirby-Bauer disc diffusion methods. Exactly 59.65% and 40.35% of the identified Klebsiella spp and E. coli isolates respectively were confirmed to be ESBL producers. The bacterial isolates were highly resistant (89%-100%) to ceftazidime, amoxicillin, aztreonam, cefpirome, cefoxitin, cefotetan, and cefotaxime. However, imipenem was the most active antibiotic against the bacterial isolates as they were highly susceptible to this antibiotic (64%-71%). This study has revealed that E. coli and Klebsiella spp colonize orthopedic wounds. They were also multidrug-resistant with Multiple Antibiotic Resistance Index (MARI) values within the range of 0.20 to 0.85. The increasing prevalence of bacterial resistance to antibiotics has made susceptibility testing a crucial aspect in the treatment of serious bacterial infections. Therefore, there is need for increased surveillance of ESBL-producing organisms as they pose serious threat to successful treatment of infections and exacerbates the problem of antimicrobial resistance in the hospitals, especially in resource poor settings.

Study of Extended Spectrum Beta-Lactamases Producing Escherichia Coli and Klebsiella Species in a Tertiary Care Hospital, Biratnagar, Nepal

“…All ESBL producing E. coli and K. species were found (100.0%) susceptibility to meropenem. Similarly, other antibiotic also showed increased susceptibility towards the piperacillin/tazobactum (97.2%), cefoperazone/ sulbactum (94.4%) and amikacin (93.0%), and which was similar to study conducted by Singh N et al [18] and Iroha IR et al [19].The ESBL producing organisms are increasing rapidly and becoming a major problem in the area of infectious diseases which includes multi drug resistance, difculty in detection and treatment and increase in mortality of patients. As compared to other available antimicrobial agents, carbapen-emes are the drug of choice and are reliable for treatment for infections caused by ESBL isolates.…”

Isolation and Phenotypic Characterization of Extended Spectrum Beta-lactamase Producing Bacteria from Urinary Tract Infection Patients in Adamawa State, Nigeria

“…From this study, S. aureus (29%) is the most prevalent U.T.I with women accounting for 33 of the 44 isolates, followed by E. coli most prevalent gram-negative bacteria accounting for the 21% (31/150) of the U.T.I isolated, this in agreement with most of the recent studies of U.T.Is and could be attributed to differences in geographical locations and standards of hygiene [4][5][6][7]15].…”

“…Moreover, several studies establishing the presence of ESBL Producing clinical bacterial isolates from specific localities within the western and eastern part of the country have also been reported, ESBLproducing Gram-negative bacteria are emerging and impacting significantly on the management of patients and treatment costs [4].…”

Phenotypic and genotypic detection of antibiotic resistance among Pseudomonas aeruginosa isolates from orthopedic wounds from Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (Coouth), Awka Anambra Nigeria

“…Plates were incubated at 37°C for 18 to 24 h. Strains were considered ESBL-positive when the difference of zone diameters between the beta-lactam disc and disc containing antibiotic associated with clavulanic acid was > 5 mm. Suspected ESBL producers were further subjected to Double Disc Synergy Test (DDST) for phenotypic confirmation [9].…”