Background and Objectives: Carbapenem-resistant Pseudomonas aeruginosa, are among the top tier of the list of antibiotic-resistant priority pathogens that pose the greatest threat to human health. In recent years, the rate of carbapenem resistance in Pseudomonas aeruginosa has increased worldwide and has become of great concern since it significantly restricts the therapeutic options for patients. Therefore this study was undertaken to determine the antibiotic susceptibility profile of the clinical isolate of Carbapenem-resistant Pseudomonas aeruginosa.
Methodology: A total of five hundred (500) clinical samples were collected from patient’s attending Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State (AFEUTHA). The collected samples were analyzed for the presence of Pseudomonas aeruginosa using standard microbiological techniques for isolation and characterization of bacteria. Further strain confirmation was performed using VITEK 2 System. Phenotypic detection of Carbapenem-resistant Pseudomonas aeruginosa was performed using Modified Hodge testing. Antibiotic susceptibility was performed by employing Kirby-Bauer disk diffusion method and the results were interpreted using the Clinical Laboratory Standard Institute (CLSI) zone diameter breakpoints.
Results: The occurrence rate of Pseudomonas aeruginosa in clinical samples accounted for 119(23.8%) consisting of a high proportion from urine sample 81(27.4%) followed by wound swabs 13(25.5%), high vaginal swabs 17(20.7) while the least occurrence rate was observed against catheter tips 5(12.8%) and sputum 3(9.4%). Modified Hodge testing revealed 31(6.2%) carbapenem-resistant Pseudomonas aeruginosa comprising of high proportion of 24(8.1%) from urine samples followed by wound swab 5(9.8%) while Carbapenem-resistant Pseudomonas aeruginosa was absent in High Vaginal Swab recording 0(0.0%). Carbapenem-resistant Pseudomonas aeruginosa isolates were highly resistant to amoxicillin-clavulanic 100%, colistin 100%, tetracycline 100%, nitrofurantoin 70.8%, aztreonam 87.5% but were susceptible to nalixidic acid 50.0 %, ofloxacin 75.0%, and ciprofloxacin 100%.
Conclusion: As in-vitro susceptibility of carbapenem-resistant Pseudomonas aeruginosa isolates to ofloxacin and ciprofloxacin is known, their judicious utilization will accelerate a significant improvement in the patient's condition. As such, there is a substantial need for the evaluation of a wide spectrum and new therapies in different classes to counteract this imminent crisis of resistance among Carbapenem-resistant Pseudomonas aeruginosa.
Background and Objectives: Over time, the enzymes AmpC β-lactamases have become more significant, due to their roles in antibiotic resistance among enterobacteriaceace especially in Escherichia coli and Klebsiella pnuemoniae. Due to increase multidrug resistant express by AmpC β-lactamases producing bacteria strain, the patients care in several hospital has been severely hampered. Hence, this study was designed to assess the occurrence of CIT and DHA AmpC β-lactamase gene in Escherichia coli and Klebsiella pnuemoniae from clinical sample in south eastern, Nigeria
Methodology: This study was conducted over an 8-month period on sixteen (16) non-repetitive clinical isolates of Escherichia coli and Klebsiella pnuemoniae collected from medical microbiology laboratory unit of Alex Ekweume Federal University Teaching Hospital in Abakaliki, Nigeria. The isolates were further identified using Standard microbiological Techniques and screened for cefoxitin resistance using a disc diffusion assay, followed by phenotypic tests using phenyl boronic acid assays for confirmation of AmpC β-lactamases production. Escherichia coli and Klebsiella pneumoniae strains were further screen for AmpC β-lactamase CIT and DHA genotype by polymerase chain reactions
Result: Of the sixteen (16) confirmed phenotypic AmpC β-lactamase producing bacteria, 100% of the AmpC β-lactamase genes (DHA and CIT) were detected in E. coli from wound and urine samples from both male and female patients. The overall proportion of AmpC β-lactamases gene in Klebsiella pneumoniae were DHA (100 %) and CIT (100 %), in both male and female.
Conclusion: This study indicate the occurrence of CIT and DHA AmpC genotype. The detection of AmpC β-lactamases in this study is of clinically importance as such bacteria are often MDR. Thus, being aware of the presence of AmpC β-lactamase-producing bacteria could be very beneficial for achieving more accurate epidemiological results as well as controlling their spread, while surveillance is required to track any further dissemination and emergence of other AmpC β-lactamase genotypes.
Background: Swine is one of the major sources of protein to humans worldwide, antimicrobial-resistant Escherichia coli has become a global public health challenge affecting both humans and livestock due to presence of tetracycline resistance genes. Aim: This study focused on molecular identification of tetracycline resistance genes (tet A and B) in E. coli isolates from internal organs of swine sold in a slaughterhouse at Abakaliki, Ebonyi State, Nigeria. Methods: A total of 75 internal organs of swine samples were collected from slaughterhouses. Standard microbiological procedures were employed to evaluate the samples bacteriologically. Using the disk diffusion method, antibiotic susceptibility testing was conducted on E. coli against specific classes of antibiotics, and the multiple antibiotic resistance index (MARI) was calculated. The Polymerase Chain Reaction was utilized for the molecular identification of the tetracycline resistance genes, specifically tet A and B. Results: Out of the 75 samples analyzed, 24/75 were positive for E. coli with an overall prevalence of 24/75 (32.0%). The small intestine and colon had higher percentages of E. coli isolates 6/15 (40.0%). However, E. coli isolates were resistant to erythromycin, tetracycline, and ampicillin which ranged from 20.0% to 75.0% and susceptible to gentamycin, and ciprofloxacin at a range of 75.0% to 100.0%. Exactly 8 (33.3%) isolates were both multidrug and tetracycline resistant. The presence of tet A 6/8 (75.0%); tet B 5/8 (62.5%); tet A and B 4/8 (50.0%) were reported. Conclusion: Multidrug and tetracycline resistance genes have been observed in E. coli isolated from internal organs of swine and is of public health concern.
Background and Objectives: In recent years, the rate of carbapenemase encoding gene in P. aeruginosa has increased worldwide and has become of great concern since it’s significantly restricts the therapeutic options for patients in Tertiary health care. Therefore, there’s a need for molecular characterization of carbapenemase encoding genes in Pseudomonas aeruginosa from Tertiary Healthcare in South Eastern Nigeria.
Methodology: A total of twelve (12) Pseudomonas aeruginosa positive culture of Urine (n=5), Wound swab (n=5), Catheter tip (n=2) were collected from Alex Ekwueme Federal University Hospital Teaching Hospital, Abakaliki (AE-FUTHA), Ebonyi State, South eastern Nigeria. The Pseudomonas aeruginosa strain confirmation was performed using VITEK 2 System and the bacteria were further screen for carbapemase encoding gene by PCR specific primer.
Results: Molecular amplification of carbapenemase encoding genes revealed that blaNDM and blaIPM accounted 12 (100%) across all sample source. Among the various sample sources, blaKPC was found 1(8.3%) in Urine, wound swab 3(25.0%), and Catheter tip 1(8.3%), while blaVIM was found 2(16.7%), 2(16.7%) and 0(0.0%) in Urine, wound swab and Catheter tip respectively. Co-expression of blaNDM + blaIMP accounted 5(41.6 %), 5(41.6 %) and 2(16.7 %) in Urine, wound swab and Catheter tip respectively. Co-expression of blaKPC + blaNDM + blaVIM + blaIMP + blaOXA was only detected in urine 1(8.3 %).
Conclusion: The current study gives an account of the presence of carbapenemase-encoding genes in P. aeruginosa. The expression of carbapenemase-encoding genes may be the mainstay of phenotypic MDR. As a result, physicians, other medical professionals, researchers, and public health policymakers must be kept up to date on the spread of carbapenemase-encoding genes. In addition, strict infection prevention and control strategies, as well as antimicrobial stewardship programs, are highly desirable in admission healthcare facilities where carbapenemase-encoding genes are spreading.
Background and Objectives: AmpC β-lactamase producing Escherichia coli has emerged in hospital environments as an important health issue that is of a global health concern as drug-resistant pathogenic bacteria that has evolved into strains that are resistant to many classes of antibiotics. However, awareness of the prevalence of AmpC β-lactamase producing microorganisms such as E. coli could be very valuable for achieving more accurate epidemiological results, as well as controlling their spread in the different hospital wards.
Methodology: A total of four hundred (400) clinical samples comprising of two hundred and seventy-nine (279) urine samples and one hundred and Twenty-one (121) wound samples were collected from patients in different ward at AE-FUTHA. The clinical samples were analyze using standard microbiological culture and identification of Escherichia coli. Detection of phenotypic AmpC β-lactamases production was performed using Cefoxitin-Cloxacillin Double-Disk Synergy Test (CC-DDST). Antibiotic susceptibility studies of AmpC β-lactamases producing Escherichia coli was determined using the Kirby–Bauer disk diffusion method and the results were construed using the Clinical Laboratory Standard Institute (CLSI) zone diameter breakpoints.
Results: Phenotypic AmpC β-lactamases producing E. coli accounted overall prevalence rate of 94.1%. The frequency of AmpC β-lactamases producing E. coli in urine samples were 57(93.4%) comprising of high occurrence rate in Surgical ward 15(100%) followed by medical ward 24(88.9%) but also accounted for overall prevalence rate of 38(95.0%) in wound samples consisting of 9(100 %) from children ward and medical ward 10(100%) followed by Orthopedic ward 13(86.7%) with the least prevalence rate. The AmpC β-lactamases producing E. coli exhibited high percentage of resistance within the range of 50-100% against ceftriaxone, ceftazidime, cefepime, azetronam, Trimethoprim-Sulfamethoxazole Ticarcillin-clavulanic acid but were susceptible to ofloxacin 70.0%, Imipenem 83.3% and amikacin 100%.
Conclusion: The findings of this study is a proof of the occurrence of AmpC β-lactamase producing Escherichia coli among patients admitted to hospital wards and there’s an urgent need for controlling and managing the development of MDR genotype strain. Moreover, to prevent the spread of resistance among AmpC β-lactamase producing Escherichia coli to other strains and improve the effectiveness of antibiotics, it is suggested to establish a precise schedule for antibiotic use in each region based on their antibiotic resistance pattern.
In Nigeria, poultry farming contributes significantly to the economy. Antibiotic use in poultry farming may promote the emergence of multidrug-resistant Staphylococcus aureus, a pathogen of human diseases that inhabit body cavities like the nostrils. This study assessed multi-drug-resistant Staphylococcus aureus in nasal carriage among poultry farmers and butchers in Abakaliki, Ebonyi State, Nigeria. A total of 300 nasal swabs of poultry farmers and butchers in slaughters from New Layout Market and Josephine Elechi Poultry Farm were analyzed in the Microbiology Laboratory Unit of Ebonyi State University. Results showed that Staphylococcus aureus occurrence rates were 20% (poultry farm A), 17% (poultry farm B), 15% (poultry slaughter A), and 16% (poultry slaughter B). Methicillin-resistant Staphylococcus aureus (MRSA) prevalence rates were 11% (39 handlers) and 14% (39 butchers). Antibiotic sensitivity tests revealed high resistance to lincomycin (100%), clindamycin (100%), doxycycline (94.7%), vancomycin (89.5%), erythromycin (89.5%), trimethoprim (73.3%), and ciprofloxacin (60.5%) in poultry farm A. Poultry Farm B samples exhibited resistance to doxycycline (93%), trimethoprim (72%), vancomycin (86.1%), erythromycin (83.7%), lincomycin (100%), and piperacillin-tazobactam (95.4%). Poultry slaughter A samples displayed resistance to doxycycline (100%), trimethoprim-sulfamethoxazole (80%), vancomycin (86.7%), erythromycin (93.3%), lincomycin (100%), and clindamycin (100%), while samples from poultry slaughter B showed resistance to erythromycin (100%), lincomycin (100%), clindamycin (100%), doxycycline (92.6%), vancomycin (88.9%), and trimethoprim-sulfamethoxazole (74.1%). Multiple antibiotics resistance index (MARI) was 0.7 among poultry farmers and 0.6 among poultry butchers provokes great concern. Therefore, our findings emphasized the importance of judicious antibiotic use and preventive measures to control MRSA spread in the poultry industry.
Background and Objectives: Carbapenemase-producing bacteria are super bugs that make Urinary Tract Infections (UTIs) difficult to treat with drug of last resort such as carbapenem and other antibiotic thus limiting the treatment options. Carbapenemase production is increasing in clinical isolates of E. coli and K. pneumoniae, their potential to spread widely among patients necessitates molecular detection of carbapenemase-producing Escherichia coli and Klebsiella pneumoniae implicated in Urinary Tract Infection.
Methodology: A total of twelve (12) non-repeated clinical isolate of Escherichia coli (E1, E2, E3, E4, E5, E6, E7) and Klebsiella pneumoniae (K8, K9, K10, K11, K12) were selected based on their in vitro phenotypic resistant to carbapenem antibiotics from patients diagnosed with urinary tract infection at Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AE-FEUTHA) Ebonyi Sate Nigeria. Escherichia coli and Klebsiella pneumoniae were further confirmed using standard routine microbiological technique for isolation and identification of bacteria. Escherichia coli and Klebsiella pneumoniae strains were further screen for carbapenemase-producing gene by PCR specific primer.
Result: PCR analysis with specific primer for carbapenemase gene revealed the presence and predominant of blaKPC in Escherichia coli and Klebsiella pneumoniae 12(100 %) followed by blaNDM 11(91.7 %), blaIMP 7(58.3 %) and blaVIM 2(16.7) as the least carbapenemase-producing gene in Escherichia coli and Klebsiella pneumoniae. blaKPC was predominant in Escherichia coli 7(58.3 %) followed by blaNDM 6(50.0 %) and blaIMP 5(41.7 %) while both blaOXA and blaVIM (16.7 %) were the least detected carbapenemase gene. Klebsiella pneumoniae harbor high proportion of blaNDM and blaKPC both recording 5(41.7 %) followed by blaOXA and blaIMP both recording 2(16.7 %) but blaVIM gene was not identified in Klebsiella pneumoniae.
Conclusion: The current findings highlight the occurrence of carbapenemase-producing gene in Escherichia coli and Klebsiella pneumoniae implicated in UTI. Since these genes are carried on the bacteria plasmid there is a tendency of cross-species dissemination over time. The detection of carbapenemase-producing gene call for prompt epidemiological surveillance and preventive strategies to limit the spread of these carbapenemase resistant genetic determinant and the need for antibiotic susceptibility testing of available antibiotic agent.
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.
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