Prevalence of extended-spectrum beta lactamase and AmpC producing Enterobacteriaceae among diabetic patients in Bauchi State, Nigeria

Abstract

Diabetes mellitus (DM) is a diverse group of metabolic disorder which is often associated with a high disease burden in developing countries such as Nigeria. It is one of the dreaded complications leading to repeated hospitalizations and even amputation, drastically reducing the quality of life. Hence proper management of infections among diabetic patients and choosing appropriate antibiotic is crucial. The study aimed to determine the prevalence of Extended Spectrum Betalactamase (ESBL) and Ampicillinases (AmpC) producing Enterobacteriaceae from diabetic patients attending some hospitals in Bauchi state. A total of 196 samples were collected from diabetic patients attending Abubakar Tafawa Balewa University Teaching Hospital Bauchi, Bauchi state. The samples were processed according to standard microbiological techniques, Gram negative; oxidase negative isolates were suspected as Enterobacteriaceae and were confirmed using API20E kit. Antimicrobial susceptibility testing was done using disc diffusion method, ESBL and AmpC production were detected using double disc synergy test and disc approximation assay respectively. A total of 74 (37.8%) Enterobacteriaceae were isolated from study participants, age group 11 to 85 years comprising of 103 male and 93 female, the most frequently isolated enterobacteriaceae was Escherichia coli which has 41(20.9 %,) while the least occurring was Enterobacter spp with 3 (1.5%). Antibiotic screening shows 58 (78.4%) of the isolates were resistant to third generation cephalosporin antibiotics, 54.0% were resistant to cephamycin (cefoxitin). Extended-spectrum Beta lactamase (ESBL) production was noted among 38 (51.3%) of the total isolates, followed by 25 AmpC producing enterobacteriaceae (33.8%), statistically there is significant association between inpatient (hospitalizes diabetes patients) and ESBL producing enterobacteriaceae in the study area (P-value = 0.04).