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Research Article Open access CC BY 4.0

Prevalence and Antibiogram Profile of Carbapenem-resistant Escherichia coli and Klebsiella pneumoniae among Patients with Urinary Tract Infection in Abakaliki, Nigeria

Onyinye Lovette Nomeh, Ezinwanne Blessing Chukwu, Rebecca Chinenye Ogba, Peace Oluchi Akpu, Ikemesit Udeme Peter, Agabus Chidiebube Nwuzo, Ifeanyichukwu Romanus Iroha

International Journal of Pathogen Research · pp. 57–71 · Published 28 Dec 2022

10.9734/ijpr/2022/v11i3212

Abstract

Background and Objectives: Carbapenem antibiotic are drug of last-resort from the treatment of bacterial infection, as a result of the prevalence and rapidly evolving enzymes from Carbapenem resistant bacteria such Escherichia coli and Klebsiella pneumoniae make urinary tract infection difficult, and in some cases impossible to treat in health care settings. With limited progress of new antibacterial drugs, the best approach is monitoring the prevalence and antibiogram profile of carbapenem-resistant Escherichia coli and Klebsiella pneumoniae among patients with UTI in Abakaliki, Nigeria. Methodology: A non-repetitive, clean catch mid-stream urine was collected from five hundred (500) diagnosed UTI inpatient and outpatient. The samples were evaluated using routine microbiological protocol for isolation and identification of Escherichia coli and Klebsiella pneumoniae. Phenotypic screening of Carbapenem-resistant strains was performed using Modified Hodge Testing. Antibiogram studies of carbapenem-resistant Escherichia coli and Klebsiella pneumoniae was performed using the Kirby–Bauer disk diffusion method and the results were interpreted using the Clinical Laboratory Standard Institute (CLSI) zone diameter breakpoints. Multiple antibiotic resistance index (MARI) was determined for MDR strain. Result: The prevalence of Escherichia coli and Klebsiella pneumoniae isolate accounted for 148(29.6 %) consisting of 95(54.3 %) and 53(16.3 %) from in-patients and out-patients. Escherichia coli accounted overall isolation rate of 112(22.4 %) comprising of high proportion among in-patient 82(46.9 %) over out-patient 30(9.2 %). The proportion of K.  pneumoniae accounted for 36(7.2 %) with 13(7.4 %) and 23(7.1 %) recorded among in-patients and out-patients. Association between presence of Escherichia coli and Klebsiella pneumoniae isolates in clinical samples was statistically significant with patient’s population with p value <0.05. Carbapenem-resistant Escherichia coli and Klebsiella pneumoniae accounted for 37(7.4 %) comprising of 24(13.7) and 13(4.0 %) among in-patients and out-patients respectively while carbapenem-susceptible Escherichia coli and Klebsiella pneumoniae accounted for overall detection rate of 111(22.2 %) consisting of 71(40.6 %) and 40(12.3 %) among in-patients and out-patients respectively. The isolates resistance rate to cephalosporins were relatively high i.e., Cefotaxime, Cefoxtin Ceftazidime, Ceftriaxone resistance was observed at 60-100% while amoxicillin/clavulanate, azetronam, tetracycline nitrofurantoin and Ticarcillin-clavulanic acid recorded 100 % with MDR index ranged from 0.5-0.8, but were 100 % and 85.0 % sensitive to ciprofloxacin and ofloxacin. Conclusion: These results strongly hypothesize that MDR bacteria, including Carbapenem-resistant isolate, have become common residents in various hospital environments, however with substantial evidence in this study, ciprofloxacin and ofloxacin as drugs of choice could be used for treatment of UTI. Therefore, its importance that good antibiogram evaluation of other drug classes beside fluoroquinoles reported in this study need to be establishes as baseline for empirical diagnosis, epidemiological surveillance, drug prescriptions and infection management.

Urinary tract infection carbapenem-resistant Escherichia coli Klebsiella pneumoniae

References (42)

  1. 1 Current Status and Trends of Antibacterial Resistance in China [DOI]
  2. 2 The mgrB gene as a key target for acquired resistance to colistin in Klebsiella pneumoniae [DOI]
  3. 3 Multicenter Clinical and Molecular Epidemiological Analysis of Bacteremia Due to Carbapenem-Resistant Enterobacteriaceae (CRE) in the CRE Epicenter of the United States [DOI]
  4. 4 Multidrug-resistant and extended-spectrum beta-lactamase (ESBL)-producing Salmonella enterica (serotypes Typhi and Paratyphi A) from blood isolates in Nepal: surveillance of resistance and a search for newer alternatives [DOI]
  5. 5 Multidrug resistant and carbapenemase producing Enterobacteriaceae among patients with urinary tract infection at referral Hospital, Northwest Ethiopia [DOI]
  6. 6 Ongoing spread of colistin-resistant Klebsiella pneumoniae in different wards of an acute general hospital, Italy, June to December 2011 [DOI]
  7. 7 Risk factors for aquiring multidrug-resistant organisms in urinary tract infections: A systematic literature review [DOI]
  8. 8 An Update of the Evolving Epidemic of blaKPC Carrying Klebsiella pneumoniae in Sicily, Italy, 2014: Emergence of Multiple Non-ST258 Clones [DOI]
  9. 9 Dissemination of blaNDM-5 gene via an IncX3-type plasmid among non-clonal Escherichia coli in China [DOI]
  10. 10 Antimicrobial Resistance in Bacterial Pathogens and Detection of Carbapenemases in Klebsiella pneumoniae Isolates from Hospital Wastewater [DOI]
  11. 11 Factors associated with community-acquired urinary tract infections among adults attending assessment centre, Mulago Hospital Uganda [DOI]
  12. 12 Outbreak of KPC-3-producing, and colistin-resistant, Klebsiella pneumoniae infections in two Sicilian hospitals [DOI]
  13. 13 Prevalence of colistin resistance in clinical isolates of Enterobacteriaceae: A four-year cross-sectional study [DOI]
  14. 14 Molecular epidemiology of Carbapenem-resistant Klebsiella pneumoniae in a paediatric hospital in China [DOI]
  15. 15 Resistance phenotype and clinical molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae among pediatric patients in Shanghai [DOI]
  16. 16 blaNDM-5 carried by a hypervirulent Klebsiella pneumoniae with sequence type 29 [DOI]
  17. 17 Molecular epidemiology of carbapenem-resistant Enterobacterales in Thailand, 2016–2018 [DOI]
  18. 18 Prevalence, antimicrobial susceptibility pattern and associated risk factors for urinary tract infections in pregnant women attending ANC in some integrated health centers in the Buea Health District [DOI]
  19. 19 Antibiotic resistance and detection of plasmid mediated colistin resistance mcr-1 gene among Escherichia coli and Klebsiella pneumoniae isolated from clinical samples [DOI]
  20. 20 Determining the susceptibility of carbapenem resistant Klebsiella pneumoniae and Escherichia coli strains against common disinfectants at a tertiary hospital in China [DOI]
  21. 21 Antimicrobial Resistance and Healthcare Associated Infections [DOI]
  22. 22 Colistin Resistance among Enterobacteriaceae Isolated from Clinical Samples in Gaza Strip [DOI]
  23. 23 PATTERN OF MULTIDRUG RESISTANT BACTERIA ASSOCIATED WITH INTENSIVE CARE UNIT INFECTIONS IN IBADAN, NIGERIA.
  24. 24 Detection of NDM Variants (blaNDM-1, blaNDM-2, blaNDM-3) from Carbapenem-Resistant Escherichia coli and Klebsiella pneumoniae: First Report from Nepal [DOI]
  25. 25 Phenotypic and molecular characterization of antimicrobial resistant Escherichia coli from urinary tract infections in Port-Harcourt, Nigeria [DOI]
  26. 26 The emergence of blaOXA-48 and blaNDM among ESBL-producing Klebsiella pneumoniae in clinical isolates of a tertiary hospital in Iran [DOI]
  27. 27 Molecular-diversity, Prevalence and Antibiotic Susceptibility of Pathogenic Klebsiella Pneumoniae under Saudi Condition [DOI]
  28. 28 Identification and Antibiotic Resistance Profile of Biofilm-forming Methicillin Resistant Staphylococcus aureus (MRSA) Causing Infection among Orthopedic Wound Patients [DOI]
  29. 29 Molecular Detection of New Delhi Metallo Beta Lactamase 1 (NDM-1) Producing Bacterial Isolates in Kano- Northwestern Nigeria [DOI]
  30. 30 Prevalence of ESBLs secreting and carbapenem-resistant E. coli from urinary tract infection
  31. 31 Prevalence and Susceptibility Analysis of Gram Negative Pathogens in Tertiary Care Transplant Hospital, Mumbai [DOI]
  32. 32 Urinary Tract Infections Among Female Students Of The University Of Agriculture, Makurdi, Benue State, Nigeria [DOI]
  33. 33 Carbapenem-resistant Enterobacteriaceae (CRE)
  34. 34 Phenotypic Characterization and Antibiogram of Non-Oral Bacteria Isolates from Patients Attending Dental Clinic at Federal College of Dental Technology and Therapy Medical Center Enugu [DOI]
  35. 35 Detection of Extended Spectrum Beta-Lactamase Producing Escherichia coli from Urinary Tract Infection in General Hospital, Minna [DOI]
  36. 36 Isolation and molecular characteristics of extended spectrum beta-lactamase-producing uropathogenic Escherichia coli isolated from hospital attendees in Ebonyi State, Abakaliki [DOI]
  37. 37 Prevalence Of Extended Spectrum Beta-Lactamases (ESBLs)-Producing Escherichia Coli Isolated From UTI Patients Attending some Selected Hospitals In Minna, Nigeria [DOI]
  38. 38 In vitro activity of newer and conventional antimicrobial agents, including fosfomycin and colistin, against selected gram-negative bacilli in Kuwait [DOI]
  39. 39 Frequency and Antibiotic Resistance of Enterobacteriaceae Isolated in Community Urinary Tract Infections at Tebessa Region [DOI]
  40. 40 Evaluation of Resistance Mechanisms in Carbapenem-Resistant Enterobacteriaceae
  41. 41 Antibiotic Resistance Profile of Escherichia coli from Urine of Patients with Suspected Urinary Tract Infections in Federal Medical Centre, Keffi, Nigeria [DOI]
  42. 42 The Search for a Practical Method for Colistin Susceptibility Testing: Have We Found It by Going Back to the Future? [DOI]

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