Carbapenem Resistance among Extended Spectrum Beta-Lactamases Producing Escherichia coli and Klebsiella pneumoniae isolates from Patents with Urinary Tract Infections in Port-Harcourt, Nigeria.
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Abstract
Extended Spectrum Beta-Lactamases (ESBLs) producing urinary bacteria with reduced susceptibility to carbapenems are a serious public health problem that is making the treatment of urinary tract infections (UTIs) a difficult task. Thus, this study investigated the prevalence of carbapenem resistance among ESBLs producing Escherichia coli and Klebsiella pneumoniae isolates from UTIs patients in Port Harcourt, Nigeria. Three hundred non-duplicated urine samples of UTIs patients deposited at the medical laboratory of University of Port Harcourt Teaching Hospital were collected, cultured and screened for the presence of Escherichia coli and Klebsiella pneumoniae isolates using standard microbiological techniques. The confirmed isolates were screened for phenotypic ESBLs expression and antibiotic susceptibility testing was carried out on the ESBLs positive isolates using Kirby-Bauer disc diffusion method. A total of 64 E. coli and 108 Klebsiella pneumoniae isolates were recovered and a total 81 (47.1%) of all the isolates expressed ESBLs production. The E. coli isolates were found to significantly expressed higher proportion of ESBLs enzymes than the Klebsiella pneumoniae (Odds ratio = 1.993, P = 0.030). E. coli and Klebsiella pneumoniae isolates exhibited very high resistance (73-100%) to most of the tested antibiotics and moderate resistance (35-48%) to ertapenem. The prevalence of multi-drug resistance (MDR) among the isolates was 100%. The high prevalence of carbapenem resistance in this study calls for very stringent measures on the prudent use of antibiotics and infection control program through the promotion of hand hygiene in order to reduce the spread of MDR pathogens in our society.
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