Main Article Content
Multi-drug resistant bacterial strains have been increasingly implicated in clinical infections worldwide and beta-lactamase production is one of the commonest mechanisms of resistance in these strains. This study investigated the prevalence of extended spectrum â-lactamase (ESBL)-producing isolates and determined the temoneira (TEM) and sulfhydryl variable (SHV) types implicated in two military hospitals in South-South Nigeria.
Three-hundred and eighty (380) consecutive non-duplicate bacterial isolates (Gram negative bacilli) recovered from clinical samples were identified following standard techniques. Antimicrobial susceptibility tests were performed for each isolate following the Clinical Laboratory Standards Institute guidelines. Bacterial isolates recovered which comprised Escherichia coli, Klebsiella spp, Proteus spp and Pseudomonas aeruginosa were screened for ESBL using a phenotypic method (double disc synergy test). All positive isolates were screened for TEM and SHV genes by PCR method.
Sixty-five isolates (17.1%) were ESBL producing using phenotypic method, E. coli showed the highest ESBL prevalence (24.3%). One isolate was SHV positive (1.5%), 8 (12.3%) were TEM positive while 3 (4.6%) isolates harbored both SHV and TEM genes. Fluoroquinolone - ofloxacin showed marked activity against ESBL-producing isolates (90.8%) while the least active were ceftriaxone (9.2%), ceftazidime (3.1%) and ampicillin (1.5%).
This study demonstrated that 17.1% of Gram-negative bacilli were ESBL producers. Screening of clinical isolates for ESBL should be implemented. The findings of this study suggest the need for caution in the use of antimicrobial agents in order to curb the incidence of antimicrobial resistance.
The journal allows the authors to hold the copyright without restrictions and allow the authors to retain publishing rights without restrictions.
Malloy AMW, Campos JM. Extended-spectrum beta-lactamases: a brief clinical update. Pediatr Infect Dis J 2011;30:1092–3. doi: 10.1097/INF.0b013e31823c0e9d.
Aibinu IE, Pfeifer Y, Ogunsola F, et al. Emergence of β-lactamases OXA-10, VEB-1 and CMY in Providencia species from Nigeria. J Antimicrob Chem 2011;66:1931–2. https://doi.org/10.1093/jac/dkr197.
Shaikh S, Fatima J, Shakil S, Rizvi SMD, Kamal MA. Antibiotic resistance and extended spectrum beta-lactamases: types, epidemiology and treatment. Saud J Biol Sci 2015;22:90–101.
Jeannot K, Fournier D, Müller E, et al. Clonal dissemination of Pseudomonas aeruginosa isolates producing extended-spectrum β-lactamase SHV 2a. J Clin Microb 2013;51:673-5. doi: 10.1128/JCM.02313-12.
Abreu AG, Marques SG, Monteiro-Neto V, et al. Nosocomial Enterobacteriaceae infection and characterization of extended-spectrum β-lactamases-producing in northeast Brazil. Rev Soc Bras Med Trop 2011;44:441-6. http://dx.doi.org/10.1590/S0037-86822011000400008.
Ogbolu, DO, Daini OA, Ogunledun A, et al. High levels of multidrug resistance in clinical isolates of Gram-negative pathogens from Nigeria. Int J Antimicrob Agents 2011;37:62-6. doi: 10.1016/j.ijantimicag.2010.08.019.
Ibadin EE, Omoregie, R, Enabulele OI. Prevalence of extended spectrum β-lactamase, AmpC β-lactamase and metallo-β-lactamase among clinical isolates recovered from patients with urinary tract infections in Benin City, Nigeria. N Z J Med Lab Sci 2018; 72:11-6.
Ibadin EE, Omoregie R, Igbarumah OI, et al. Prevalence of extended spectrum β-lactamase, AmpC β-lactamase and metallo-β-lactamase among Gram negative bacilli from clinical specimens in a tertiary hospital in Benin City, Nigeria. Int J Ent Path 2017;5:85-91. doi: 10.15171/ijep.2017.20.
Barrow GI, Feltham RKA. Cowan and Steel’s Manual for the Identification of Medical Bacteria. 3rd ed. Cambridge: Cambridge University Press; 2003.
Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing: Twenty-fourth Informational Supplement M100-S24. Wayne, P.A., USA:CLSI;2014
Kaur J, Chopra S, Sheevani, Mahajan G. Modified double disc synergy test to detect ESBL production in urinary isolates of Escherichia coli and Klebsiella pneumonia. J Clin Diagn Res 2013;7:229–33. doi: 10.7860/JCDR/2013/4619.2734.
Monsi TP, Abbey SD, Wachukwu CK, et al. Plasmid-mediated resistance in extended spectrum beta–lactamase–producing Klebsiella pneumoniae isolates at Rivers State University Teaching Hospital. Eur J Pharm Med Res 2019;6:75-82.
Mahamat OO, Lounnas M, Hide M, et al. High prevalence and characterization of extended-spectrum ß-lactamase producing Enterobacteriaceae in Chadian hospitals. BMC Infect Dis 2019;19:205. doi: 10.1186/s12879-019-3838-1.
Yusuf I, Haruna M, Yahaya H. Prevalence and antibiotic susceptibility of ampC and ESBL producing clinical isolates at a tertiary health care center in Kano, North-West Nigeria. Afr J Clin Exper Microb 2013;14:109-19. http://dx.doi.org/10.4314/ajcem.v14i2.12.
Andrew B, Kaginta A, Bazira J. Prevalence of extended-spectrum beta-lactamases-producing microorganisms in patients admitted at KRRH, Southwestern Uganda. Int J Microb 2017; 3183076. doi.org/10.1155/2017/3183076
Ogbolu, DO, Alli O, Webber MA, et al. CTX-M-15 is established in most multidrug-resistant uropathogenic Enterobacteriaceae and Pseudomonaceae from hospitals in Nigeria. Eur J Microb Immun 2018;8:20-4. doi: 10.1556/1886.2017.00012.
Ogbolu DO, Alli OA, Olanipekun LB, Ojo OI, Makinde OO. Faecal carriage of extended-spectrum beta-lactamase (ESBL)-producing commensal Klebsiella pneumoniae and Escherichia coli from hospital out-patients in Southern Nigeria. Int J Med Medic Sci 2013;5:97-105. doi: 10.5897/IJMMS12.0005.
Sharma M, Pathak S, Srivastava P. Prevalence and antibiogram of Extended Spectrum β-Lactamase (ESBL) producing Gram negative bacilli and further molecular characterization of ESBL producing Escherichia coli and Klebsiella spp. J Clin Diagn Res 2013;7:2173-7.
European Medicines Agency. Disabling and potentially permanent side effects lead to suspension or restrictions of quinolone and fluoroquinolone antibiotics. Amsterdam: European Medicines Agency;2019.
Redgrave LS, Sutton SB, Webber MA, Piddock LJV. Fluoroquinolone resistance: mechanisms, impact on bacteria, and role in evolutionary success. Trends Microbiol 2014; 22: 438–45. doi: 10.1016/j.tim.2014.04.007.