Low Prevalence of Carbapenem Resistance in Clinical Isolates of Extended Spectrum Beta Lactamase (ESBL) Producing <i>Escherichia coli</i> in North Central, Nigeria

Abstract

Extended Spectrum Beta Lactamase (ESBL) producing Escherichia coli is a global cause of life threatening infections. We determined the presence of ESBL and carbapenemase production in clinical isolates of E. coli and their antibiotic susceptibility. Clinical isolates of community and hospital acquired E. coli from 220 patients seen at a tertiary hospital were evaluated. Antibiotic susceptibility testing was by the modified Kirby-Bauer protocol while ESBL production was determined by the Double Disk Synergy Test (DDST). Carbapenem resistance was confirmed by the Modified Hodge Test. Of the 220 isolates, 122 (55.5%) were from females; 41 (18.6%) were ESBL positive. About 90% of the ESBL producing isolates were resistant to nine of the 15 antimicrobial agents tested. However, only one (2.4%) of the 41 ESBL producing isolates exhibited carbapenem resistance. The ESBL negative isolates were susceptible to Meropenem (100%), Cefepime (97.8%), Ceftriaxone (96.6%) and Cefotaxime (96.6%). All the ESBL producing isolates harbored detectable plasmids with sizes ranging from 2322 to 23,130 base pairs. Our findings show that although multidrug resistant ESBL producing E. coli are prevalent in both the hospital and the community in this environment, carbapenem resistance is still low. We recommend that institutions develop guidelines for the early phenotypic detection of ESBLs and carbapenem resistance.

Emergence of bla TEM resistance gene in ESBL-producing Escherichia coli clinical isolates from Health facilities in Makurdi, Benue State Nigeria

“…Demographic data showed that female population carried a higher burden of ESBL infections than the male counterpart and the age group most affected is 45 to 58 years. This is in agreement with the report of [20] from Jos, North-Central Nigeria.…”

“…It is however, higher than 3.3% reported from Gaza strip [2], 11.8% from Macedonia [9]. Our finding is similar to the report of 18.6% by [20] from a neighboring Plateau State, Jos, North-Central Nigeria and 18.5% by [17] in India.…”

Prevalence and drug-resistance profile of plasmid-borne extended spectrum beta-lactamase (ESBLs) resistance genes in multidrug resistant Escherichia coli from HIV-1 positive individuals in Jos, Nigeria

“…The prevalence in our study is however lower than the 56.7, 70.0, 72, 83.0 and 95.5% reported by Irith et al (2007), Igwe et al (2016), Horsefall et al (2017) Husam et al (2009 and Wani et al (2009), respectively. It is however higher than the 18.6% earlier reported by Onyedibe et al (2018) in Jos. This difference may be attributed to the use of molecular technique in our study as against phenotypic detection in theirs, since the latter is known to be less sensitive compared to the former.…”

“…This indicates that IPM is still a choice drug for the treatment of MDR bacteria in the region. Nevertheless, other similar studies (Onyedibe et al, 2018, Adesola et al, 2020 reported varying levels of resistance (18.6 and 20.6%, respectively) to the drug. This suggests the need for close monitoring, so as to track and control the spread of resistance.…”

First Detection of Carbapenem-Resistant Escherichia fergusonii Strains Harbouring Beta-Lactamase Genes from Clinical Samples

“…Most multidrug-resistant ExPEC isolated from bacterial infections in Nigeria are ESBL producers harbouring multiple beta-lactamase genes [21][22][23][24]. Moreover, recent studies on carbapenem-resistant Enterobacteriaceae infections in Nigeria have identified multidrug-resistant extraintestinal Escherichia sp.…”