Incidence and antibiotic susceptibility profile of uropathogenic Escherichia coli positive for extended spectrum β-lactamase among HIV/ AIDS patients in Awka metropolis, Nigeria

Chikaodili J. Nwokolo; Malachy C. Ugwu; Chika P. Ejikeugwu; Ifeanyichukwu R. Iroha; Charles O. Esimone

doi:10.18502/ijm.v14i3.9770

Chikaodili J. Nwokolo Department of Pharmaceutical Microbiology & Biotechnology, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Awka, Nigeria
Malachy C. Ugwu Department of Pharmaceutical Microbiology & Biotechnology, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Awka, Nigeria
Chika P. Ejikeugwu Department of Applied Microbiology, Faculty of Science, Ebonyi State University, Abakilikii, Ngeria
Ifeanyichukwu R. Iroha Department of Applied Microbiology, Faculty of Science, Ebonyi State University, Abakilikii, Ngeria
Charles O. Esimone Department of Pharmaceutical Microbiology & Biotechnology, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Awka, Nigeria

DOI: https://doi.org/10.18502/ijm.v14i3.9770

Keywords: HIV; Drug resistance; Uropathogenic Escherichia coli; Antimicrobial resistance; Extended-spectrum β-lact- amase

Abstract

Background and Objectives: This study investigated the incidence and antibiotic susceptibility profile of extended spec- trum β-lactamase (ESBL) producing uropathogenic Escherichia coli recovered from HIV/AIDS patients in Awka metropolis, Nigeria.

Materials and Methods: A total of 363 urine samples were bacteriologically analyzed for the isolation of E. coli isolates which were further characterized using standard microbiology techniques. The isolated uropathogenic E. coli was tested for susceptibility to a range of clinically important antibiotics using the modified disk diffusion technique. All E. coli isolates were phenotypically screened for ESBL production using the combined disk technique, and strains which were positive were further confirmed for the presence of ESBL genes using PCR technique.

Results: A total 160 (44.1%) non-duplicate isolates were bacteriologically confirmed to be uropathogenic E. coli (UPEC). The E. coli isolates showed reduced susceptibility to important antibiotics including ceftazidime (76.88%), cefuroxime (77.5%), cefixime (61.88%), amoxicillin-clavulanic (32.5%) and ciprofloxacin (34.38%). Twenty-seven of the UPEC iso- lates were phenotypically confirmed to be ESBL producers. PCR test confirmed some important genes mediating ESBL production in Gram negative bacteria including bla TEM (5.0%) and bla CTX-M-15 (6.9%) genes.

Conclusion: We report a high prevalence of ESBL producers among HIV/AIDS patients in Awka, Nigeria. This result is important as antibiotic resistance (ABR) particularly those mediated by multidrug resistant bacteria as reported in this current study could complicate treatment outcome, worsen the individual’s health, and even increase cost of treatment and hospital- ization. It is therefore important to lookout for ESBL positive UPEC amongst HIV/AIDS patients in Nigeria.