Phenotypic Detection of Extended Spectrum Beta lactamase and Carbapenemase Co-producing Clinical Isolates from Two Tertiary Hospitals in Kano, North West Nigeria

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Yusuf Ibrahim
Yahaya Sani
Qabli Saleh
Algarni Saleh
Gbadamosi Hakeem

Abstract

BACKGROUND: Continue rise in unprofessional use ofantibiotics in our hospitals and communities is worrisome. Aresearch study was therefore conducted to detect extendedspectrum beta-lactamase (ESBL), carbapenemase, metallobetalactamase and their co-production phenotypically from isolatesobtained from patients admitted to or attending two tertiaryhospitals in Kano, Nigeria.METHOD: A total of 248 isolates of Escherichia coli andKlebsiella pneumoniaewere screened phenotypically for ESBLproduction and carbapenemase production according to CLS12012 breakpoints using double disk synergy test and modifiedHodge test (MHT) respectively. Antibiotic susceptibility of theorganisms was tested against colistin, tigecycline and 3flouroquinolones.RESULT: The result shows that 58.0% of the isolates were ESBLproducers with higher percentage in K. pneumoniae (62.9%).Further, about 40.3% and 36.6% of the isolates were resistant tomeropenem and imipenem respectively. However, E. coli showedhigher resistance to meropenem (47.1%) while K. pneumoniaeshowed higher resistance to imipenem (44.4%). Co-productions ofcarbapenemase and ESBL were observed in both E. coli and K.pneumoniae. Carbapenemase producing isolates were moreobtained from uro-pathogens and wound isolates, with almost allthe cases of co-production of the β lactamases occurring in urineand cathertips isolates. Overall susceptibilities of the isolates tocolistin and tigecycline were 64.6and70.0% respectively, butisolates were less susceptible to flouroquinolones.CONCLUSION: The finding of the study therefore indicates thatcarbapenem resistance is mediated by carbapenemase productionand or overproduction of ESBL coupled with reduced porins. Co-production of carbapenemase, MBLs and ESBLs by some of theisolates is worrisome. Susceptibility to colistin and tigecycline wasstill promising, but increasing resistance to flouroquinolones hasbeen observed.

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Author Biographies

Yusuf Ibrahim, Bayero University, Kano,Nigeria

Department of Microbiology, Faculty of Science

Yahaya Sani, Bayero University, Kano,Nigeria

Department of Microbiology, Faculty of Science

Qabli Saleh, KingAbdulaziz University, Jeddah, SaudiArabia

Department of Microbiology

Algarni Saleh, KingAbdulaziz University, Jeddah, SaudiArabia

Department of Microbiology

Gbadamosi Hakeem, Katsina, Nigeria

Federal Medical Center