Prevalence and antibiotic susceptibility of AmpC and ESBLs producing clinical isolates at a tertiary health care center in Kano, north-west Nigeria

Abstract

The increase in production of Extended Spectrum Beta Lactamase (ESBL) and Amp C beta lactamase among clinical isolates in our hospitals is of utmost importance. Failure to detect these enzymes in many of our hospitals has greatly led to treatment failure and uncontrolled spread of multi drug resistant pathogens. It was for this purpose that the present study was conducted to determine the prevalence, distribution and susceptibility pattern of Gram negative bacteria producing ESBLs and Amp C beta lactamases in the largest tertiary health care provider in Kano, North-West Nigeria. A total of 75 ESBL and 10 AmpC producing bacteria were involved in the study which were obtained from a study involving 500 Gram negative clinical bacterial isolates from various hospital wards over a period of 9 months from Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. Isolates were screened for ESBLs and AmpC using Double Disc Diffusion Method and Amp C Disc test respectively. All confirmed ESBL and Amp C producing isolates were tested for susceptibility to sixteen (16) different antibiotics by the Disc Diffusion Method (DDM). The prevalence of ESBLs was high in Shigella spp. (1/2 or 50%), followed by Klebsiella pneumoniae (10/50 or /20%), and E. coli (47/247 or 19.3%) while Amp C producers were detected more in Klebsiella pneumoniae (4%) and E. coli (2.8%). Of the specimens screened, distribution varies between ESBL and AmpC producers, but more prevalent in urinary tract pathogens in both. Highest prevalence of ESBLs and AmpC producers was recorded in intensive care units and surgical wards. ESBL and AmpC production in the hospital is not sex dependent statistically, thought higher in males (52 and 60%) than in females (48 and 40%) for ESBL and AmpC respectively. ESBL and AmpC producers were both sensitive to Imipenem, Nitrofurantoin and Levofloxacin and resistance to Amoxycillin, Ceftazidime and Tetracycline. The study indicates the occurrence of ESBL and AmpC producers in our tertiary health provider, widely distributed in various clinical samples, wards
and sexes and are multi drug resistant posing serious threat in managing life threatening infections.

Key words: prevalence, distribution, ESBL producers, Amp C producers, antibiotic susceptibility