Molecular detection of ESBL genes in urinary pathogens from hospitalised and community patients in Ogun State, Nigeria

Abstract

Objectives: The emergence of Extended-Spectrum Beta-Lactamases (ESBL) enzymes in Enterobacteriaceae in hospitals and communities has led to therapeutic failures and increased treatment costs globally. This study isolated and identified ESBL genes from the urine samples of hospitalised patients in two selected hospitals and people living in the Oyan Dam Community, all in Ogun State, Nigeria.

Methods: A total of 416 urine samples were collected and cultured, and the isolates were identified using API 20E. Antibiotic Susceptibility Test was carried out to identify Multi-drug Resistant (MDR) bacteria using the disc diffusion method. ESBL-resistant genes were identified using TEM-1, Sulfhydryl Variable, and Cefotaxime Hydrolysing Capabilities (CTX-M) specific primers.

Results: A total of 167 (40.14%) Gram-negative bacilli were isolated. Escherichia coli 104 (62.3%), Klebsiella pneumoniae 10 (6.0%), Klebsiella ozaenae 21 (12.6%), and other bacteria were identified. A total of 106 (63.5%) isolates were identified as MDR, out of which 75 (70.8%) were Escherichia coli and five (4.7%) were Klebsiella pneumoniae. The isolates were highly resistant to ceftazidime, cefixime, gentamicin, cefuroxime and ofloxacin. ESBL production was observed in 96 (90.6%), TEM-1 gene 63 (65.6%) was predominant, CTX-M 33 (34.4%) co-existed with TEM and no SHV gene was identified.

Conclusion: This study has revealed that people in their homes may be more predisposed to drug resistance, and this may constitute a public health threat that requires social interventions. E. coli and Klebsiella pneumoniae isolates are the most prevalent causative agents in the communities, as with hospital infections.