Prevalence and risk factors of extended spectrum beta-lactamase producing bacteria among patients with lower respiratory tract infections in Benin City, Nigeria
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Lower respiratory tract infection (LRTI) continues to be a major cause of rising morbidity and mortality rates in resource limited settings with drug resistance worsening treatment outcomes. This study was aimed at determining the prevalence and risk factors of extended spectrum beta-lactamase (ESBL) producing bacteria among patients with signs and symptoms of LRTI in Benin City, Nigeria. A total of 489 patients (non-repetitive) presenting with signs and symptoms of LRTI were recruited. Questionnaires were given and filled by participants. Sputum specimens were collected from these patients in sterile wide-mouth containers and sent to the Medical Microbiology Laboratory, University of Benin Teaching Hospital for microbiological analysis. Emergent colonies were identified and antimicrobial susceptibility tests carried out using British Society for Antimicrobial Chemotherapy (BSAC) guidelines. Gram negative rods were screened for ESBL using phenotypic method. ESBL showed high prevalence among Escherichia coli (57.1%) while its lowest prevalence was observed for Pseudomonas aeruginosa (7.1%). Klebsiella pneumoniae recovered from inpatients showed high likelihood of being ESBL positive (p = 0.0046). Bacterial strains recovered from inpatients were more likely to be ESBL producing and showed significant association in comparison with outpatients (OR = 3.567; 95%CI = 1.778, 7.153; p = 0.0005). ESBL producing bacteria showed a significant relationship with educational (p < 0.0001) and occupational status (p = 0.0135). Marked level of resistance was shown to antibiotics while the carbapenems showed the highest activity against isolates. The overall prevalence of ESBL producing bacteria was 26.5%. The study advocates caution in the use of carbapenems and harps on prudent use of antibiotics.
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