Molecular Detection ctx-M, TEM and VIM in ESBL-Producing E. coli Strains Isolated from Pregnant Women in Osogbo

Abstract

Urinary tract infection (UTI) is a major bacterial infection causing serious health problem in pregnant women. The physiological and anatomical changes in pregnancy facilitate urinary tract infection (UTI) during pregnancy. Asymptomatic bacteriuria in pregnancy is associated with pyelonephritis, preterm labour and low birth weight infants. The study was designed to characterise phenotypically and genetically the major organism associated with UTI among pregnant women in Osun State. A cross-sectional study design was used to collect mid-stream urine samples between March 2018 to September 2018 from 150 pregnant and 50 non-pregnant women which serve as control. Samples were inoculated into Cysteine Lactose Electrolyte Deficient (CLED) medium, subcultured onto MacConkey and Blood agar plates. A standard agar disc diffusion method was used to determine antimicrobial susceptibility pattern of the isolates and the molecular detection of the antibiotic resistant genes were done. Data were subjected to descriptive statistics. The ages of women enrolled in this study ranges from 22 to 43 years (mean ± standard deviation = 25 ± 4.7 years). The predominant bacteria identified were E. coli (34.5%), S. aureus (10.3%), coagulase negative Staphylococci [CoNS] (17.2%), Klebsiella species (6.9%) and Enterobacter species (31.0%). Majority of Gram-negative bacteria isolates were resistant to ampicillin (70%), cefotaxime (62%), while 75–100% of the Gram positive isolates were resistant to ampicillin. Multiple drug resistance was observed, all the E. coli isolates were resistant to Cefotaxime, meropenem and ampicillin. Of E. coli isolates, 4, 3 and 6 were positive for the VIM, ctx-M and TEM genes respectively.Similarly, the risk of UTI was higher in those had previous UTI history (OR = 2.29, 95% CI = 1.15–4.56, P = 0.019) as compared to those who had no previous history of UTI.