Phenotypic and Genetic Detection of Extended-Spectrum Beta-Lactamase (ESBL)-Producing Klebsiella pneumoniae Isolates from Urinary Tract Infection Cases in Keffi, Nigeria

Abstract

Background: Multidrug-resistant Klebsiella pneumoniae are often associated with urinary tract infections in the community or hospital settings globally. Resistance resulting from the expression of the Extended-Spectrum Beta-Lactamase (ESBL) gene has been widely reported. In Nigeria, the prevalence has been reported to be between 16% to 62%. Aim: The current study focused on the isolation of K. pneumoniae associated with urinary tract infections (UTIs) using standard microbiological methods, as well as the antibiotic susceptibility profile and the detection of Extended-Spectrum Beta-Lactamase (ESBL) genes using phenotypic and genetic procedures. Study Design: The study was a cross-sectional study utilising random urine samples from patients with UTI in the selected hospitals. Place and Duration of Study: The study was performed in Keffi from July to October 2024. Keffi is a local government area of Nasarawa State, Nigeria. Methodology: Early morning midstream urine samples were randomly collected from 160 consenting participants from the six selected hospitals. The samples were cultured following standard microbiological techniques. Antibiotic susceptibility testing was performed using the Kirby-Bauer disk diffusion. ESBL producers were detected using the disk diffusion and PCR methods. Results obtained in this study were analysed using Smith’s Statistical Package (Version 2.8, California, USA) and a P value of ≤ 0.05 was considered statistically significant. The collected data were summarised using percentages as descriptive statistics. Results: A significantly high resistance to ceftazidime 20(100%) was recorded, closely followed by ceftriaxone 19(95%), streptomycin 19(95%), cefuroxime 19(95%) and amoxicillin 18(90%), chloramphenicol 17(85%). The least resistance was recorded for ciprofloxacin 8(40%), Augmentin 6(30%) and ofloxacin 6(30%). Furthermore, the majority of the isolates were found to be multidrug resistant. The blaSHV gene was detected in (60.0%) of the isolates, followed by the blaCTX-M gene (26.7%), and the blaTEM gene (13.3%). Conclusion: The detection of multidrug-resistant, ESBL-producing K. pneumoniae in this study poses significant concern. The routine detection of ESBL genes using the phenotypic method, before drugs are administered, especially in low-resource settings, is recommended.