Prevalence of carbapenem resistant escherichia coli and klebsiella pneumoniae in urine samples of patients attending selected general hospitals within Kaduna Metropolis

Abstract

Carbapenem-resistant Enterobacteriaceae(CRE) is a growing concern worldwide. The study was conducted to determine the prevalence of carbapenem resistant Escherichia coli and Klebsiella pneumoniae from urine of suspected urinary tract infected patients from (5) General Hospitals within Kaduna metropolis. Following the collection of (350) urine samples, Escherichia coli and Klebsiella pneumoniae were isolated, identified and characterized using selective media (Eosin methylene blue and Macconkey agar), biochemical test and microgene kit respectively. Antibiotic susceptibility test was carried out for all the isolates using Kirby-Bauer disc diffusion technique. The isolates that are resistant to morepenem and ertapenem were amplified to detect the resistance genes. The PCR amplified DNA products were examined for the common ESBL-encoding genes (bla TEM and bla SHV) and carbapenem resistance genes (blaKPC, blaNDM and blaVIM). In all the hospitals, female respondents recorded the highest prevalence (74%) than the male (25%). Among the study population, Escherichia coli was the most prevalent (28%) followed by Klebsiella pneumoniae (13%).Among the five age groups, (≤10, 11-20, 21-30, 31-40 and 41years and above), (31-40) recorded the highest prevalence (5.4%) of Escherichia coli and Klebsiella pneumoniae. Among the twelve antibiotics used, Klebsiella pneumoniae recorded the highest number of resistant drugs. On the prevalence of Escherichia coli and Klebsiella pneumoniae resistance to meropenem and ertapenem, (6.1%) was recorded for Escherichia coli and (6.5%) for Klebsiella pneumoniae, which is slightly higher when compared with the previous report of (5.2%) and (2.5%) for Escherichia coli, and (7.8%) and (5.5%) for Klebsiella pneumoniae. Following the examination of PCR Amplified DNA products, the ESBL genes (bla TEM and blaSHV) were detected while for the carbapenemase, only blaVIM gene was detected, with the absence of blaKPC and blaNDM genes. Detection of these genes constitutes an alarming threat, and have been the cause of country-wide epidemics of healthcare associated infections. There should be regular and strict monitoring of Carbapenem resistance among the Enterobacteriaceae from time to time in all general and teaching hospitals, as to curtail the rising incidence along with the public health burden associated with these resistance genes.