Point-surveillance of antibiotic resistance in Enterobacteriaceae isolates from patients in a Lagos Teaching Hospital, Nigeria

• Published in: Journal of infection and public health Vol. 6; no. 6; pp. 431 - 437
• Main Authors: Raji, Muhabat Adeola, Jamal, Wafaa, Ojemhen, Omoh, Rotimi, Vincent O
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01-12-2013; Elsevier
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antibacterial agents; Antibiotic resistance; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Child; Child, Preschool; Drug Resistance, Bacterial; Enterobacteriaceae; Enterobacteriaceae - drug effects; Enterobacteriaceae - isolation & purification; Enterobacteriaceae Infections - epidemiology; Enterobacteriaceae Infections - microbiology; Epidemiological Monitoring; ESBL; Female; Hospitals, Teaching; Humans; Infant; Infectious Disease; Internal Medicine; Lagos; Male; Medical sciences; Microbial Sensitivity Tests; Middle Aged; Nigeria; Nigeria - epidemiology; Pharmacology. Drug treatments; Prevalence; Young Adult; Nigeria; Africa; ESBL; Lagos; Nigeria; Antibiotic resistance; Enterobacteriaceae; Human; Resistance; Antibiotic; Teaching hospital; Surveillance; Bacteria; Antibacterial agent
• ISSN: 1876-0341; 1876-035X
• DOI: 10.1016/j.jiph.2013.05.002

Summary Objectives This study was carried out to determine a point prevalence of drug resistance and extended-spectrum β-lactamase (ESBL) among members of the family Enterobacteriaceae. Methods Consecutive clinically significant non-repetitive isolates obtained from both hospitalized patients and outpatients’ samples were studied. The isolates were identified using VITEK 2 while susceptibility testing was performed against 16 antibiotics using the E -test strips. Phenotypic production of ESBL was detected by E -test ESBL method. Positive isolates were confirmed by PCR. Results Of a total of 102 isolates studied, 43 (42.2%) were Escherichia coli and 32 (31.4%) Klebsiella pneumoniae . These isolates demonstrated remarkable high rates of resistance to the β-lactam antibiotics, except the carbapenems and piperacillin–tazobactam. Fifty-two (51%) were resistant to ≥3 classes of drugs and 29 (28.4%) to ≥5 drugs. Thirty-eight (37.3%) were ESBL producers. Of these, 21 (55.3%) were E. coli and 12 (31.6%) K. pneumoniae . Thus, the overall prevalence of ESBL-producing E. coli was 20.6% and K. pneumoniae 11.8%. Conclusions This study showed an alarmingly high prevalence of antibiotic resistance in invasive Enterobacteriaceae isolates and a high prevalence of ESBL producers in the study center. Antibiotic stewardship and other preventive strategies are recommended to reduce the high rate of resistant bacteria in this hospital.