PREVALENCE OF CTX-M-PRODUCING GRAM-NEGATIVE UROPATHOGENS IN SOKOTO, NORTH WESTERN NIGERIA
Background: Infections of the urinary tract remains one of the most common bacterial infections with many implicated organisms being Gram-negative, with increasingly resistant to antimicrobial agents. The study evaluate the resistance of the ESBL producing Gram negative enterobacteriaceae to commonly prescribed antibiotics and the prevalence of CTX-M genes from these isolates using polymerase chain reaction (PCR).
Methods: The isolates were collected from urine over a period of 4 months and studied, and were identified using Microgen Identification Kit (GN-ID). Susceptibility testing was performed by the modified Kirby Bauer disc diffusion method, and results were interpreted according to Clinical Laboratory Standard Institute (CLSI). Extended Spectrum Beta-Lactamase (ESBL) production was detected by double disc synergy test (DDST). Molecular characterization was based on the isolates that were positive for phenotypic detection of ESBL.
Results: Sixty one (61) isolates of Gram-negative uropathogens were identified. Of these, 19 (31.2%) were E. coli, 15 (24.6%) were Salmonella arizonae, Klebsiella pneumoniae were 7 (11.5%), Klebsiella oxytoca were 3 (4.9%), Enterobacter gergoviae were 6 (9.8%), 4 (6.6%) were Citrobacter freundii, 4 (6.6%) were Serratia marscence, and 1 (1.6%) were Enterobacter aerogenes, Proteus mirabilis, and Edwardsiella tarda each. Analysis of the bacterial susceptibility to antibiotics revealed most of them to be generally resistant to cotrimoxazole (73.3%), nalidixic acid (66.7%), norfloxacin (53.5%), ciprofloxacin (50.5%), gentamicin (48.6%), amoxicillin/clavulanate (45%), and the least resistant was displayed in nitrofurantoin (30%). Of the 15 ESBL producers, 11 (73.3%) were harbouring bla CTX-M genes.
Conclusion: The study revealed a high susceptibility to nitrofurantoin, whereas susceptibility to cotrimoxazole was lowest. It further portrays a high prevalence of enterobacteriaceae isolates harbouring bla CTX-M genes in Sokoto metropolis.
Key words: Resistance, Prevalence, Gram-negative, Urinary Tract Infections, CTX-M.
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