Molecular Epidemiology of Extended Spectrum Beta-lactamases Producing Escherichia coli and Klebsiella Species in Catheterized Patients

Abstract

Irrational antibiotics use has added to the escalation of antibiotics resistance, especially among hospitalized patients on prolonged urethral catheterization, a significant risk factor for urinary tract infection and urosepsis. Extended-spectrum β-lactamases are transferable plasmid-mediated resistance mechanism orchestrated majorly by Enterobacteriaceae, which confer resistance to β- lactam antibiotics and other classes of antibiotics. This work was aimed at determining the molecular characteristics of uropathogenic Escherichia coli and Klebsiella spp involved in urinary tract infections among patients on prolonged urethral catheterization in two major tertiary hospitals in Lagos. One hundred and one samples were collected from participants in Lagos University Teaching Hospital and 68 Army Reference Hospital Yaba, between November 2015 and May 2016. The mean age of the participants was 49.04± 8.8years.
 Single, non -repeat aseptically aspirated urine specimens from the catheter ports were obtained from consenting participants and processed immediately. Bacterial species were isolated and characterized by conventional methods. Antibiotics susceptibility testing was done using a modified Kirby Bauer method. Further analysis was done by Polymerase Chain Reaction amplification aimed to detect bla SHV, bla TEM, and bla CTX-M resistance genes. Isolates were considered significant if there were up to 104 CFU/ml in symptomatic participants and ≥105 CFU/ml in asymptomatic participants with analyzed. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 16.0 (Inc., Chicago 111). Forty (39.6 %) males and 61 (60.4 %) female participants’ catheter urines were sampled, with male to female ratio of 1:1.5.
 Fifty-nine (58.4%) out of 101 samples had significant growth, while 32 (54.2%) of these were lactose fermenters. Of the 32 lactose fermenters, 26 were identified as E. coli and Klebsiella spp, while 23 (88.5%) of these 26 (identified as E. coli and Klebsiella spp) were ESBL producers carrying ESBL gene(s) and revealed various degrees of antibiotics resistance. We conclude by discussing the epidemiological importance of improving the infection control practices and antibiotics stewardship program as central dogma to controlling antibiotics resistance in hospitals.

Antibiogram Audit of Catheter-associated Uropathogenic Isolates in University of Calabar Teaching Hospital, Calabar, Nigeria: Advocating Laboratory-based Prescription Practices

“…There was no case of polymicrobial CAUTI, attributable to the fact that the durations of catheterization of participants in the study were in the short term range of <30 days [24] The isolates of CAUTI in this study were majorly E. coli (32.7%), Pseudomonas aeruginosa(25%), Klebsiella pneumoniae (15.4%), C. albicans (7.6%), Proteus mirabilis (5.8%), Staphylococcus aureus (3.8%), Coagulase Negative Staphylococcus (1.9%) and Enterococcus faecalis (1.9%). This array of isolates conformed with the microbial growth pattern in short term catheterization [25] In all, E. coli (32.7%) was the dominant isolate in this study and this is similar to the result of a related study in Dhaka, Bangladesh [26] but different from the finding in a similar study [27] at the Lagos University Teaching Hopital, Lagos, Nigeria which reported Klebsiella pneumoniae as the dominant isolate.…”

Antibiotic resistance and virulence profiles of Proteus mirabilis isolated from broiler chickens at abattoir in South Africa

“…ESBLs are plasmid‐encoded enzymes that cause resistance to extended‐spectrum cephalosporins, monobactams and aztreonams (CDC, 2019 ). Recently, an increase in ESBL‐producing Enterobacteriaceae has been observed globally (Ushie et al., 2020 ).…”

“…Recently, an increase in ESBL-producing Enterobacteriaceae has been observed globally (Ushie et al, 2020).…”