Resistance to Third-Generation Cephalosporins and Other Antibiotics by Enterobacteriaceae in Western Nigeria

Abstract

Problem statement:The emergence and spread of resistance to third-generation cephalosporins are threatening to create species resistant to all currently available agents. The most common cause of bacterial resistance to beta-lactam antibiotics is the production of beta-lactamases and many of the 2nd and 3rd-generation penicillins and cephalosporins were specifically designed to resist the hydrolytic action of major β-lactamases. However new β-lactamases emerged against each of the new classes of β-lactams that were introduced and caused resistance. This study was designed to determine the rate of resistance to 3rd-generation cephalosporins and other classes of antibiotics by the Enterobacteriaceae in this environment. Approach: One hundred bacteria isolates belonging to the family Enterobacteriaceae identified from different clinical specimens between October and December 2007 using standard bacteriological methods. These were subjected to antibiotic susceptibility testing to third-generation cephalosporins and other classes of antibiotics which included quinolones and an aminoglycoside using the Kirby-Bauer method of disc diffusion test. Results: Out of the total number of Enterobacteriaceae isolated in the study period, only 54.8% of the klebsiella species isolated were sensitive to ceftazidime, 48.4% to ceftriaxone and 30.7% to cefotaxime. With Escherichia coli however, the susceptibility pattern to the 3rd-generation cephalosporins was better (65.6% were sensitive to ceftazidime, 62.5% to ceftriaxone and 71.9% to cefotaxime). In proteus species, the susceptibility pattern was generally poor to the three classes of antibiotics(50% were sensitive to ceftazidime and ceftriaxone, 0% to cefotaxime, 33.3% to ciprofloxacin, 50% to gentamycin and 0% to amoxycillin/clavulanate). Conclusion/Recommendations:The poor susceptibility to amoxicillin/clavulanate demonstrated by all the isolates in this study showed the probability of new beta-lactamases production.Further studies therefore need to be done in this environment to determine the types of the β-lactamases produced by the Enterobacteriaceae here, the prevalent rate of such isolates and the molecular analysis of the new β-lactamases produced.

Antibiogram and plasmid profiling of carbapenemase and extended spectrum Beta-lactamase (ESBL) producing <I>Escherichia coli</I> and <I>Klebsiella pneumoniae</I> in Abeokuta, South western, Nigeria

“…The public health implication of continuous dissemination of such multi-resistant bacteria with high frequency transmissible DNA cannot be overlooked. With the increased attention being paid to stricter infection control practices across our country 2,25 , it is pertinent to note that health authorities as a matter of urgency should include molecular epidemiology in its infection control policy. This is in order to detect changing patterns and emergence of new resistance genes before wide spreads dissemination occurs.…”

Prevalence of Extended Spectrum Beta Lactamase (ESBL) Producing Escherichia coli and Klebsiella pneumoniae Isolated from Raw Milk Samples in Al Jazirah State, Sudan

“…The use of cephalosporins in food-producing animals could be selective factor for the appearance of ESBL-producing and multipleantimicrobial-resistant bacteria in such animals [39]. On the other hand, increasing resistance to third generation cephalosporins (for example, cefotaxime, ceftazidime, ceftiriaxone) has become a cause for concern about Enterobacteriaceae [40]. In recent years, ESBLproducing Enterobacteriaceae isolates have shifted from the hospital to the community and the environment [41].…”

Bacterial isolates from swab specimens and their susceptibilities to antibacterial agents in Maiduguri Metropolitan City, Nigeria

“…The coliforms bacteria like Escherichia coli (17.4%), Klebsiella spp (11.4%), and Proteus spp (9.4%) were similarly isolated particularly from the ear and high vagina swab specimens of patients who presented with otitis media and urinary tract infections, respectively but Alpha-haemolytic streptococci were the least isolated agents (1.3%) while Pseudomonas spp isolation was 9.9% (Table 1). These bacterial isolates are not in contrast with the works of other researchers (Brown and Izundu, 2004;Okon et al, 2004;Okesola and Makanjuola, 2009;Alsaimary et al, 2010) but their proportions vary due to geographical or environmental factors.…”

“…The activities of ciprofloxacin (91%), ceftriaxone (75%) and amoxicillin/clavulanic acid (16%) are better than the 33%, 50% and 0% respectively recorded with these drugs in South-west Nigeria (Okesola and Makanjuola, 2009). All the isolated Proteus spp are multidrug-resistant pathogens (Table 3) making it the highest in this study.…”