Antimicrobial Resistance Pattern and Molecular Characterization of Escherichia coli producing ESBLs from patients with Urinary Tract Infection in State Specialist Hospital, Maiduguri, Borno State Nigeria

Abstract

ABSTRACT
The emergence of multidrug resistant Escherichia coli associated with urinary tract infections (UTIs) is a serious public healthcare problem globally, causing frequent morbidity and even death due to limited therapeutic options. This study investigated the antimicrobial resistance pattern and molecular characterization of Escherichia coli producing ESBLs from patients with urinary tract infection in State Specialist Hospital, Maiduguri, Borno State Nigeria. The urine samples of 400 patients were obtained from State Specialist Hospital Maiduguri and were cultured for significant bacteriuria. The E. coli isolates were identified using standard microbiological procedures and confirmed using Polymerase chain reaction (PCR) analysis. Antimicrobial resistance patterns of the isolates were determined by the modified Kirby Bauer’s disc diffusion technique and the isolates were screened for phenotypic expression of ESBLs enzyme using a combination disc method while the ESBLs genes were detected using PCR analysis. This study identified 7.5% prevalence of E. coli isolates in UTIs patients with higher proportion among the females. The isolates exhibited 60-100% resistance to Cefotaxime, Co-trimoxazole, Meropenem, Ciprofloxacin, Ceftazidime and Amoxicillin/clavulanic acid and 10-24% resistance to Imepenem and Gentamicin. Multidrug resistance (MDR) was exhibited in all the 30(100%) isolates. A total of 27(90%) of the isolates possessed ESBLs genes and the detected genes were blaCTX-M 5(16.7%), blaTEM 14(46.7%), blaSHV/TEM 1(3.3%) and blaCTX-M/TEM 7(23.3%). The findings in this study further emphasizes the need for antimicrobial stewardship with one health approach which will provide timely data for effective antibiotic treatment policy, necessary to preserve the efficacy of antibiotics that are commonly used for the treatment of patients with UTIs