Multidrug resistant Escherichia coli among patients with gastrointestinal tract infections seeking health care services at Lafia, Nigeria (original) (raw)
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https://www.ijrrjournal.com/IJRR\_Vol.8\_Issue.9\_Sep2021/IJRR-Abstract051.html, 2021
Multidrug resistance among Escherichia coli causing urinary tract infections (UTIs) and diarrhea are major public health problem worldwide which cause difficulty in treating the infections caused by Escherichia coli due to the high resistances. The study is aimed to determine the phenotypic and molecular detection of multidrug resistant E. coli isolated from clinical samples of patients attending selected Hospitals in Damaturu, Yobe State-Nigeria. Methods: Two hundred (200) clinical samples were collected aseptically from patient diagnosed with (100 stool samples) and UTI’s (100 urine samples) using sterile universal container. The samples were processed using standard microbiological methods for identification of E. coli. Samples were cultured on MacConkey agar (stool) and Cystine lactose electrolyte deficient agar (urine). The resulting colonies of isolates were further subculture on Eosin methylene blue agar for confirmatory and followed by gram stain, biochemical identification at Microbiology laboratory unit of Yobe State Specialist and Yobe State Teaching Hospital respectively. The antimicrobial susceptibility patterns were determined using Kirby-Bauer disc diffusion techniques and the phenotypic expression of extended spectrum beta-lactamases (ESBLs) were determined using modified double disc synergy test (MDDST) and also the three (3) resistance genes (blaTEM, accC1 and qnrA) were detected using polymerase chain reaction. Results: One hundred and twenty-two (122) isolates were resistant to antibiotics. The highest level of resistance was against amoxicillin (90.2%) while the least resistance was against sparfloxacin (24.3%). Thirty-seven (37) E. coli isolates shows MDR; the highest MDR was (24.3%) while least MDR was (5.4%). The PCR amplification of resistant genes (blaTEM, accC1 and qnrA) were detected on E. coli that shows positive ESBL and the bands were separated using agarose gel electrophoresis. Conclusion: The findings of this study show augmentin, ciprofloxacin and sparfloxacin are the most effective antibiotics against E. coli isolated from patients attending the two hospitals in Damaturu; who are diagnose with UTI and diarrheic infection. The resistant genes include; blaTEM, accC1 and qnrA coding for beta-lactam, aminoglycoside and quinolones were present in E. coli isolated from patients attending selected Hospitals in Yobe State, Nigeria.
African Journal of Microbiology Research, 2019
Antimicrobials have been playing an important role in preventing illness and death associated with infections due to bacteria. However, the emergence and spread of resistance by pathogens have decreased the effectiveness of the commonly prescribed antimicrobials. Intestinal Escherichia coli are among bacterial pathogens that are endowed with such resistance traits because they are important source and reservoir of genes that encode antimicrobial resistance. To determine the antimicrobial resistance profile of fecal isolates of E. coli from diarrheic patients. Stool samples were collected consecutively from 100 individuals who visited Selam Health Center during the study period, April to June 2018. Samples were collected and transported under sterile condition to the National Clinical Bacteriology and Mycology reference Laboratory, Ethiopian Public Health Institute. The samples were streaked on MacConkey agar and incubated overnight at 37°C. E. coli isolates were further confirmed using conventional biochemical tests. Antimicrobial susceptibility status was determined using the disk diffusion method on Mueller Hinton agar as recommended by the Clinical Laboratory Standard Institute. The raw data was compiled and entered to spreadsheet and analysis was done using SPSS Version 20 with p-value ≤0.05 considered statistically significant. Out of the 100 patients, 43 were female and the rest were male. Confirmed E. coli were isolated from 73 individuals. Antimicrobial susceptibility testing showed that E. coli isolated in this study were highly resistant to trimethoprim-sulfamethoxazole 49 (67.1%) and amoxicillin-clavulanic acid 47(64.4 %). No isolates showed resistance to gentamicin and tobramicin. Of all the isolates, 11(15.1%) were multidrug resistant. No association was observed between antimicrobial resistance status and sex of individuals included in this study. However, there was an association between age and resistance patterns. Resistance to commonly prescribed antibiotics among E. coli isolated in this study was high and a considerable proportions of the strains were multidrug resistant. This is an indication for an alarming rate of resistance of intestinal E. coli to first line antimicrobials. To reduce the problem, regular monitoring and education for the community are very important.
2020
ABSTRACT<br> Introduction: Escherichia coli is a facultatively anaerobic bacilli and microbiota of the gastro intestinal tract. It causes about 2 million deaths yearly through extra-intestinal and intestinal infections. Diagnosis and treatment of patients seem to be dependent on the detection of extended spectrum beta-lactamase (ESBLs) enzymes which hydrolyse antibiotics belonging to the cephalosporin and penicillin group rendering them ineffective on pathogens. This study aimed to detect ESBL encoding genes in E. coli isolated from various clinical specimens and to determine the relationship between the genes and their antibiotic susceptibility pattern.<br> Methods: Clinical isolates of E. Coli obtained from Laboratories in various clinics in Calabar, were re-identified and subjected to antibiotic susceptibility testing. Double disc synergy test was used for phenotypic detection of ESBL in isolates while conventional PCR method served the purpose for assessing ESBL enco...
Introduction: The emergence of multidrug resistance (MDR; resistance to ≥ 2 more antimicrobials) in Escherichia coli is of concern due to complications encountered in treatment. Methodology: In this study, prevalence, antimicrobial resistance, and genetic characteristics of MDR community isolates of E. coli from Lagos, Nigeria were determined. Urine and stool samples were obtained from outpatients attending Lagos State hospitals and from animal handlers in abattoirs, poultries, and open markets, from December 2012 to July 2013. Results: Approximately 50% of urine (200/394) and 88% of stool samples (120/136) were positive for E. coli. Based upon β-lactamase production, a subset of those isolates was selected for further study. Of the 22 antimicrobials tested, E. coli exhibited resistance to all antimicrobials except amikacin and piperacillin/tazobactam. The highest levels of resistance were to tetracycline (182/247; 73.7%), trimethoprim/sulfamethoxazole (152/247; 61.5%), and ampicillin (147/247; 59.1%). Resistance to the cephalosporins ranged from 1.6%–15% including the third-and fourth-generation cephalosporins, cefpodoxime (20/247; 8.1%) and cefepime (4/247; 1.6%), respectively. MDR was observed in 69.6% (172/247) of the isolates. Forty-eight E. coli resistant to at least five antimicrobials were selected for further analysis using pulsed-field gel electrophoresis; seven distinct clusters were observed among the diverse patterns. Of the 48 MDR E. coli, 30 different sequence types (ST) were detected using multilocus sequence typing, including four ST131. Conclusions: This study demonstrated circulating MDR E. coli in the Nigerian community. Monitoring of antimicrobial resistance in developing countries is necessary to optimize empiric treatment and the prudent use of antimicrobials.
The international journal of biotechnology, 2021
Escherichia coli remains one of the most isolated etiological agents of diarrhea, accounting for more than 1 million deaths and about 4% of the total global disabilityadjusted life-years (DALYS) per year across all age groups according to the global disease burden. This study evaluated multidrug-resistant Escherichia coli encoding extended spectrum beta-lactamases isolated from diarrheic patients in Minna, Nigeria using standard microbiological methods. A prevalence of 37.7% of Diarrheagenic E. coli (DEC) was obtained from the stool samples evaluated. Within the environment sampled, age group 21-30 years had the highest E. coli isolation rate (27.8%) while age group ≥71years had the least E. coli isolation rate (2.6%). Females (64.9%) were the most affected compared to males (35.1%). The isolates were significantly resistant to most of the beta-lactams tested especially to 3 rd generation cephalosporins [Cefotaxime (98.2%), cefuroxime (93%), ceftazidime (84.2%), Augmentin (70.2%), Amoxicillin (59.6%)]. Resistance to other classes of antibiotics was also observed in varying percentages. A high percentage (98.2% and 87.7%) of the diarrheagenic E. coli had a multiple resistant index (MARI) ≥ of 0.3. The isolates had varying patterns of resistance with 47.6% resistant to more than 5 classes of antibiotics tested and produced ESBL characteristics phenotypically. Molecular evaluation showed that 40%, 50%, and 90% of the isolates harbored the OXA, CTX-M and TEM genes respectively while 50% harbored VEB and PER genes. This study isolated E. coli from diarrheic patients with multidrug resistance profiles and encodes more than one type of ESBL gene within Minna, Nigeria. Contribution/Originality: This study established the prevalence and multidrug resistance profile patterns of Escherichia coli encoding ESBL genes from diarrheic patients in Minna, Nigeria. The findings also revealed a genetic diversity of ESBL genes responsible for significant resistance of Diarrheagenic E. coli to most of the beta-lactams and other classes of antibiotics.
Scientific Reports, 2022
Infections caused by multi-drug resistant Escherichia coli cause significant morbidity and mortality especially in developing countries. In this study, we describe the molecular characteristics of E. coli isolated from clinical specimens and the patients' outcomes. Phenotypic methods were used in the identification and antimicrobial susceptibility testing of E. coli from clinical specimens from a tertiary hospital in Abuja, Nigeria. Whole genome sequencing was used to describe the antimicrobial resistance genes, serotypes, sequence types/clonal complexes, and mobile genetic elements. The mean age of the patients was 20.3 years with 70.1% females and majority of isolates 75% from urine, 21% from blood cultures, and 3% each from cerebrospinal fluid and endo-cervical swabs. Of the 107 non-duplicate E. coli isolates, 101 (94.3%) were resistant to ampicillin, 95 (88.8%) to trimethoprim/ sulfamethoxazole, 86 (80.4%) to ceftriaxone, 60 (56.1%) to gentamicin, and eight (7.5%) to meropenem. There were 102 (95.3%) isolates that were multi-drug resistant (MDR). Expression of Extended Spectrum Beta Lactamase (ESBL) phenotype was detected in 54 (50%) and bla CTX-M-15 genes detected in 75 (70.1%) isolates. The carbapenemase genes bla NDM-1 and bla NDM-5 were detected in six (5.6%), while the AmpC gene-bla CMY-2 , was detected in seven (6.5%) isolates. Two (1.9%) isolates simultaneously harboured the bla OXA-1 , bla CMY-2 , bla CTX-M-15 , and bla NDM-5 genes. In total, 35 sequence types (STs) were found with the majority being ST131 (n = 23; 21.5%). The most common serotype was O25:H4 associated with all 23 strains of ST131, followed by O1:H6/ST648 (n = 6). The ST410, ST671, and ST101 strains displayed phenotypic resistance to wide array of antibiotic classes and harbored high numbers of antibiotic resistance genes via in-silico analysis. The ST410 strain in particular harbored a higher number of antibiotic resistance genes and was phenotypically resistant to a wider array of antibiotics. Four pairs of isolates were closely related with three isolates (ST131, ST38, ST652) having a pairwise SNP difference of zero. 71/72 75/76 52/14. The MDR E. coli lineages circulating in this setting pose a clinical and public health threat as they can hinder effective prevention and management of infections. The genetic diversity and MDR E. coli with the emergence of ST410 and ST101 clones is concerning because of the potential for rapid dissemination in hospitals and communities-further increasing the problems of antibiotic resistance. Continuous routine surveillance of E. coli infections for AMR in hospitals becomes imperative, aimed at development of effective antimicrobial stewardship programs, facilitating prudent use of antimicrobial agents, and limiting dissemination of resistant strains.
Annals of Clinical Microbiology and Antimicrobials, 2019
Background The use of antibiotic agents in the treatment of infectious diseases has greatly contributed to the decrease in morbidity and mortality, but these great advances in treatment are being undermined by the rapidly increasing antimicrobial resistant organisms. Extended-spectrum beta-lactamases are enzymes hydrolyzing the beta lactam antibiotics, including third generation cephalosporins and monobactams but not cephamycins and carbapenems. They pose a serious global health threat and have become a challenge for health care providers. The aim of this research was to assess the prevalence of extended-spectrum beta-lactamase producing Escherichia coli in University of Nigeria Teaching Hospital Ituku-Ozalla Enugu and to detect the risk factors for acquisition of the resistant organism. To proffer advice on antibiotic stewardship in clinical practice and public health interventions, to curb the spread of the resistant organisms in the hospital. Results Out of the 200 E. coli isolat...
Journal of Microbiology Research, 2012
Abstract There is a general increase in the attention being paid to extraintestinal Escherichia coli infections; this is because recent reports have identified various reserviour sources of multi-resistant clones of E. coli carrying mobile genetic elements capable of epidemic spread. The public health implication of an outbreak of E. coli is better imagined than experienced. We have therefore analyzed all extraintestinal E. coli isolates and their resistance profile in Abeokuta, Ogun State, Southwestern Nigeria between March 2010 and November 2010. About 339 isolates of E. coli were isolated at the Microbiology Unit of Federal Medical center, Abeokuta using standard Bacteriological techniques and tested against various antibiotics including 3rd generation Cephalosporins. Gender distribution was 105(31.0%) males and 234(39.0%) females, the highest recovery rate was recorded by age group 16-45 with 198(58.4%), followed by above 45 years 76(22.4%) and lastly 0-15 years 65(19.2%). Urine had the highest occurrence rate with 180(53.0%), followed by genital samples with 61(18.0%), and the least frequently isolated site was Blood, 27(8.0%). Other samples tested were grouped together and recorded 35(10.4%). Gentamycin was the most active antibiotic with 41.3% susceptibility against all isolates tested, followed closely by Amoxi/clav with 36.3% against all isolates tested. Very high resistance was recorded by the β-lactamases. There was poor sensitivity to the 3rd generation cephalosporins, 32.0% of isolates were susceptible to Ceftazidime and 34.4% to Cefuroxime in age group 16-45, and 46.4% susceptibility to ceftazidime were recorded against all isolates tested. In conclusion we report a high antimicrobial resistant rate in extraintestinal E. coli infection in Abeokuta with possible co-acquisition of different β-lactamase subtypes including ESBL and emerging Carbapenemases, the results of this study highlights the importance of regular surveillance of common pathogens such as E. coli in our environment. Keywords: Extraintestin
Increased multi-drug resistant Escherichia coli from hospitals in Khartoum state, Sudan
African Health Sciences, 2013
Background: Multidrug-resistant Escherichia coli (MDR E. coli) has become a major public health concern in Sudan and many countries, causing failure in treatment with consequent huge health burden. Objectives: To determine the prevalence and susceptibility of MDR E. coli isolated from patients in hospitals at Khartoum State. Methods: Between May to August 2011, E. coli (n = 232) isolated from clinical specimens, identified, tested their antimicrobials susceptibility and screened for extend spectrum â-lactamase production as per standard methods. Results: Of the 232 E. coli isolates, the majority were from urine (65.1%). MDR E. coli were present in 214 (92.2%). Of these, the resistance rates were recorded to: amoxicillin 97.7%, cefuroxime 92.5%, trimethoprim-sulfamethoxazole 88.3%, tetracycline 77.1%, nalidixic acid 72%, ceftriaxone 64%, ciprofloxacin 58.4%, ofloxacin 55.1%, amoxicillin-clavulanate 50.4%, ceftazidime, gentamicin 35% each, nitrofurantoin 22.4%, chloramphenicol, tobramicin 18.2% each and amikacin 1.9%. Overall MDR E. coli, 53.3% were resistant to > 7 antimicrobial agents and ESBL was detected in 32.7%. Isolates from males were more resistant than those from females (p < 0.05). Conclusions: Drug-resistance surveillance and epidemiological analysis of patient data is need periodically and can be informative for appropriate management of antimicrobial resistance.
Y.B. Ngwai, 2018
Aim: This study investigated antimicrobial resistance in E. coli recovered from urine of patients attending Nagari Allah Magani Hospital, Keffi, Nigeria. Place and Duration of Study: Methodology: Escherichia coli was isolated and identified from the urine of suspected UTIs patients by culture, microscopy and biochemical tests. Sample: We included 248 patients; (116 Original Research Article Eko et al.; AJRIMPS, 5(4): 1-9, 2018; Article no.AJRIMPS.45728 2 men, 132 women;age range 5-65 years). Antimicrobial Susceptibility Testing of the isolates was carried out in accordance with the Clinical and Laboratory Standards Institute (CLSI) method. Results: Out of 248 samples, the occurrence of E. coli was 43(17.3%). The occurrence of isolates in relation to age of patients was highest in 21-30 year old (26.5%) and lowest in 11-20 year olds (9.5%). The occurrence of the isolates was higher in females (21.2%) than males (12.9%). The isolates were less resistant to imipenem (20.9%), gentamicin (34.9%) and ciprofloxacin (37.3%). The commonest resistance phenotype was Amoxicillin/Clavulanic Acid-Streptomycin-Sulfamethoxazole/Trimethprim-Cefotaxime-Ceftazidime-Cefoxitin-Ciprofloxacin-Ampicillin with an occurrence of 7.0%. Most of the isolates showed multiple antibiotic resistance (MAR) Index of above 0.2 with the commonest MAR Index being 0.6 (23.8%). Most (95.6%) of isolates were classified into multidrug resistance (MDR), a few (2.3%) were non-MDR or pan drug resistance (PDR), and no extensive drug resistance (XDR) was isolated. The occurrence of classes of antibiotic resistance was of the order: MDR (95.3%) ˃ NMDR = PDR (2.3%) > XDR (0.0%). Conclusion: Resistance was less to imipenem, gentamicin and ciprofloxacin antibiotics. Most isolates originated from an environment where antibiotics are freely available and misused or abused; and are MDR isolates. Further work to detect antibiotic resistance genes in the study location should be carried out.