Antimicrobial susceptibility of extended-spectrum beta-lactamase producing Enterobacteriaceae causing urinary tract infections in Ouagadougou, Burkina Faso

Abstract

Objective: To determine the frequency of extended-spectrum beta lactamase producing Enterobacteriaceae (ESBL) and other antibioticsresistant bacteria in urinary tract isolates.

Study Design: prospective and experimental study.

Methodology: Place and duration of study :YalgadoOuedraogo University Hospital Center, Charles De Gaulle Pediatric Hospital Center, Saint Camille Hospital and National Public Health Laboratory, Ouagadougou, from November 2014 to October 2015.

AllEnterobacteriaceaestrains isolated from urinary samples of patients were identifiedusing API 20E chemical gallery (BioMerieux, France). All strains were subjected to an array of 14 antibiotics to study their drug susceptibility by using Kirby- Baeurdisk diffusion method. Detection of ESBL was carried out by double disk diffusion technique. Statistical analysis was performed by Microsoft Excel and Anova one-way GrapPad Prism version 5.01. Chi-square (χ²) test was used to determine significance. A p˂ 0.05was considered to be statistically significant.

Results: A total of 324 isolates of Enterobacteriaceae were identified during the study period, including211(65%) E. coli, 75 (23%)Klebsiella spp., 18 (6%) Enterobacter spp., 11 (3%)Proteus spp., 5 (2%) Citrobacter spp., Serratia spp. 3 (1%).All the clinical isolates were susceptible to imipenem. Resistance to amikacinwas 14% (45/324); gentamicin 54% (175/324); tobramycin 58% (187/324); nalidixic acid 72% (234/324),ciprofloxacin 63% (204/324) and to cotrimoxazole 83% (269/324).The overall rate of the EBSL producing strains was 35% (114/324). Their susceptibility to antibiotics was (imipenem,amikacin, cefoxitin and fosfomycin) 100% (114/114), 93% (106/114), 74% (84/114) and 84% (96/114) respectively. ESBL positivity within individual organism group was highest inEscherichia coli 64% (73/324) followed byKlebsiellaspp. 28% (32/324), Enterobacterspp. 3% (4/324), Proteus spp. and Citrobacterspp. 2% (2/324).

Conclusion: The results showeda high frequency of ESBL producing Enterobacteriaceae, especially Escherichia coli and Klebsiellaspp. The data points to theneed of routine detection and surveillance of ESBL producing bacteria in Burkina Faso.

Keywords: Antimicrobial susceptibility, Enterobacteriaceae, Urine, Burkina Faso