Phenotypic Detection of ESBL Production and Colistin Resistance in Escherichia Coli From Urinary Tract Infections In A Tertiary Institution In Nigeria.
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Background: Antimicrobial-resistant bacteria, particularly Escherichia coli, which produce ESBLs and the mcr1 gene, can cause urinary tract infections (UTIs) that can be fatal because there are few effective treatments. This study aims to determine the co-production of colistin resistance genes in ESBL-producing E. coli and their antibiotic susceptibility pattern from suspected UTIs in Aminu Kano Teaching Hospital using phenotypic techniques.
Method: Seventy-one (71) E. coli isolates obtained from patients with suspected urinary tract infections were studied. The identity of the isolates was confirmed using standard biochemical tests. Antibiotic susceptibility testing was carried out using the Kirby-Bauer Disc Diffusion Technique. Screening for ESBL production and colistin resistance was done using the Clinical Laboratory Standards Institute breakpoint. Suspected ESBL producers were subjected to confirmation using the Double Disc Synergy Test. Standard Discs of Augmentin (AMC 30µG, Oxoid England), Ceftazidime (CAZ 30µG, Oxoid England) and Cefotaxime (CTX 30µG, Oxoid England) were used for the screening and confirmation.
Results: Screening for ESBL production showed 67.6% suspected ESBL-producing E. coli. The Double Disc Synergy Test showed 22.9% confirmed ESBLs producing E. coli. Co-production of ESBLs and colistin resistance gene was 9.1%. Antimicrobial sensitivity of the ESBLs producing organisms showed 100% resistance to augmentin, ceftriaxone, ceftazidime and cefotaxime, while resistance to gentamicin was 90.1%, chloramphenicol 72.7%, nitrofurantoin 54.5%, ciprofloxacin 90.9% and cotrimoxazole 90.9%. A 100% sensitivity to imipenem was also observed.
Conclusion: ESBL-producing E. coli are present in Aminu Kano Teaching Hospital and are resistant to commonly prescribed antibiotics.
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