Detection of antibiotic resistance in gram-negative uropathogens isolated from suspected urinary tract infection patients in Kano State, Nigeria

Abstract

Urinary tract infection (UTI) is caused mostly by different bacteria of family Enterobacteriaceae in hospital and communities acquired infection. Emerging increasing resistance has been observed among uropathogens. The aim of the research was to evaluate current antibiotic resistance pattern of gram-negative bacteria causing UTI among patients attending Aminu Kano Teaching Hospitals in Kano, Nigeria. This research was conducted at Aminu Kano teaching hospital, Kano State, Nigeria. Two hundred and four urine samples (204) of patients who were suspected of UTI were included as the study population. The urine sample was inoculated on cysteine lactose electrolyte deficient (CLED) agar plates and incubated at 37⁰C for 24 hours. Identification was based on standard microbiological methods. The susceptibility testing was done by modified Kirby Bauer technique. Clinical laboratory standard institute (CLSI) 2024 guidelines were used for screening and confirmation of extended spectrum beta lactamase (ESBL) production. Double disk synergy method was used for confirmation of ESB. Out of 204 urine processed, 43 ( 65.2%) were gram negative and 41 were Enterobacteriaceae, isolation rates were Escherichia coli 17 (39.5%), Citrobacter spp 8(18.6%), Klebsiella pneumonia 7(16.3%), K. oxytoca 4 (9.3%), Enterobacter 3 (7.0%), Pseudomonas aeruginosa 1 (2.3%), Acinetobacter baumanni 1 (2.3%), Proteus vulgaris 1 (2.3%), Yersinia spp 1 (2.3%). Susceptibility showed that the isolates were highly susceptible to gentamycin (86.04%) and nitrofuratoin (67.5%). Resistance to third generation cephalosporins varies from 48.84% - 75.2%, while amoxicillin has 72.1% resistance. Among the isolates 9 were ESBL producers. Prevalence of ESBL was   66.7% for E. coli, 22.2 % for K. pneumonia, 11.1% for citrobacter spp. It is recommended for continuous surveillance of resistant rate among bacterial isolates causing UTI to ensure proper recommendation for the treatment of the disease.