Author(s): Ugbo Emmanuel, Anyamene Chris, Orji Jerry, Eluu Stanley, Ukpai Grace, Ogene Lilian, Okata-Nwali Divinegift
Extended-spectrum β-lactamases (ESBLs) continue to be a major challenge in clinical setups worldwide, conferring resistance to the expanded-spectrum cephalosporins. The present study focused on the prevalence of ESBL-producing E. coli clinical isolates among patients diagnosed of Wound and Urinary Tract Infections attending Federal Teaching Hospital Abakaliki. A total of one hundred and ninety two clinical isolates of E. coli was studied for their susceptibility patterns to cephalosporin antibiotics and detection of ESBL producers was carried out by double disc synergy test (DDST) and Brilliance ESBL Agar. Of the 192 isolates tested for their antibiogram, 19(9.9%), 41(21.4%), 132(68.7%); 48(25.0%) and 144(75.0%) isolates were from wound, high virginal swab, urine, male and female respectively. The isolates showed higher susceptibility to cefepime (a 4th-generation cephalosporin) with percentage susceptibility of 78.9, 85.4 and 73.5 to the isolates from wound, HVS and urine respectively. Higher resistance was recorded among the 3rd-generation cephalosporins which include Cefotaxime (63.4%), Ceftriaxone (57.9%), and Cefpodoxime (73.7%). Among the resistant isolates of E. coli, 20 isolates were phenotypically confirmed ESBL producers by the DDST and Brilliance ESBL Agar methods. Ten (10) ESBL producing E. coli was confirmed using DDST method whereas 15 ESBL producing E. coli was confirmed using the Brilliance ESBL Agar. Brilliance ESBL Agar was found to be better than DDST in the detection of ESBLs. Continuous monitoring of drug resistance and regulating the use of cephalosporin drugs in our hospitals is vital for proper infectious disease management and treatment.
ESBLs, E. coli, Patients, DDST and Brilliance ESBL Agar
- Aibinu, I. E., Ohaegbulam, V. C., Adenipekun, E. A., Ogunsola, F. T., Odugbemi, T. O and Mee, B. J. (2003). Extended-spectrum beta-lactamase enzymes in clinical isolates of Enterobacter species from Lagos, Nigeria. J. Clin. Microbiol., 41: 2197-2206.
- Arpin, C., Quentin, C., Grobost, F., Cambau, E., Robert, J., Dubois, V., Coulange, L., André, C. & on behalf of the Scientific Committee of ONERB (2009). Nationwide survey of extended-spectrum β-lactamase-producing Enterobacteriaceae in the French community setting. J Antimicrob Chemother 63, 1205–1214.
- Bauer, A. W., Truck, H. and Sherries, J. C. (1990). “Antibiotic Susceptibility testing by standardized single disc method,” American Journal of Clinical Pathology, 45: 493–496.
- Bradford, P. A. (2001). Extended Spectrum Beta-lactamases in the 21st century: Characterization, Epidemiology and Detection of this Important Resistance Threat. Clinical Microbiology Reviews, 14 (4):933-951.
- Chau, K. F and Oboegbunam, S. I. (2007). Extended – spectrum beta lactamase production among ampicillin resistant Escherichia coli strains from chicken in Enugu State, Nigeria. Brazilian J. Microbiol., 38:1-4
- Cheesbrough, M. (2010).District Laboratory Practice in Tropical Countries, Part two, 2nd edn. Cambridge University Press, UK. Pp 143-180.
- Clinical Laboratory Standards Institute (CLSI) (2006). Performance standards for antimicrobial susceptibility testing.Proceedings of the 16th International Supplement (M100-S16). Wayne, Pa, USA.
- Ejikeugwu C, Iroha I, Adikwu M and Esimone C (2013). Susceptibility and Detection of Extended Spectrum β-Lactamase Enzymes from Otitis Media Pathogens. American Journal of Infectious Diseases. 9(1):24-29.
- Health Protection Agency, HPA (2008). Laboratory detection and reporting of bacteria with extended spectrum Beta-lactamases. National Standard Method QSOP 51 Issue 2.2.
- Iroha I.R., Amadi E.S., Oji A.E., Nwuzo A.C and Ejikeugwu P.C (2010). Detection of plasmid borne extended – spectrum beta – lactamase enzymes from blood and urine isolates of Gram – negative bacteria from a university teaching hospital in Nigeria. Current Research in Bacteriology, 3(2):77-83.
- Jacoby, G. A. and Munoz-Price, L. S. (2005). Mechanisms of Disease: The New Beta-lactamases. N Engl J Med, 352: 380-91.
- Lautenbach, E., Patel, J. B., Bilker, W. B., Edelstein, P. H. and Fishman, N. O. (2001). Extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae: risk factors for infection and impact of resistance on outcomes. Clin Infect Dis. 32:1162–71.
- Laupland, K.B., Church, D.L and Vidakovich, J. (2008). Community-onset extendedspectrum b-lactamase (ESBL) producing Escherichia coli: importance of international travel. J. Infect. 57:441-448.
- Lye, D. C., Wijaya, L., Chan, J., Teng, C. P. and Leo, Y. S. (2008). Ertapenem for treatment of Extended Spectrum beta-lactamase producing and Multidrug resistant Gram negative Bacteriaemia. Ann. Acad. Med. Singapore, 37 (10): 831-4.
- Mark, E. Rupp and Paul, D. Fey (2003). Extended Spectrum Beta-lactamase (ESBL)- producing Enterobacteriaceae, consideration for diagnosis, prevention and drug treatment. Drug, 63 (4): 353-365.
- Niki, M., Hirai, I., Yoshinaga, A., Ulzii-Orshikh, L., Nakata, A., Yamamoto, A., Yamamoto, M and Yamamoto, Y. (2011). Extended-spectrum b-lactamase-producing Escherichia coli strains in the feces of carriers contribute substantially to urinary tract infections in these patients. J. Infection, 39:467–471.
- Paterson, D. L. (2006). Resistance in gram-negative bacteria: Enterobacteriaceae. Am J Med. 119:20–8.
- Paterson, D. L. and Bonomo, R. A. (2005). Extended Spectrum Beta-lactamases: A clinical update. Clinical Microbiology Review, 18:657-686.
- Pitout, J. D. D., Thomson, K. S., Hanson, N. D and Ehrhardt, A. F. (2004). Beta-lactamase responsible for resistance to extended-spectrum cephalosporin in Klabsiella pnumoniae, Escherichia coli and Proteus mirabils isolates recovered from South Africa. Antimicrob. Agents Chemother., 42: 1350-1354.
- Rodriguez-Bano, J., Lopez-Cerero, L. and Navarro, M. D. (2008). Faecal carriage of extended-spectrum b-lactamaseproducing Escherichia coli: prevalence, risk factors and molecular epidemiology. J. Antimicrob. Chemother. 62:1142-1149.
- Stephan, J. A and William, J. (2006). Eds., Koneman’s Color Atlas and Text book of Diagnostic Microbiology, Lipponcott Williams & Wilkins, 6th edition.
- Thermo Scientific Oxoid Microbiology Products (2013). Prepared Media-Ready to-use prepared plates; Brilliance ESBL Agar, Code: PO5302. www.thermoscientific.com.oxoid.
- Valverde, A., Grill, F. and Coque, T. M. (2008). High rate of intestinal colonization with extended-spectrum-b-lactamaseproducing organisms in household contacts of infected community patients. J. Clin. Microbiol. 46:2796-2799.
- Walsh, T. R., Toleman, M. A., Poirel, L and Nordmann, P. (2005). Metallo Beta-lactamases: the Quiet before the storm? Clinical Microbiology Review, 18(2): 306-325.
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