Phenotypic and molecular characterization of antimicrobial resistant from urinary tract infections in Port-Harcourt, Nigeria.

INTRODUCTION

Multidrug resistance among causing Urinary Tract Infections (UTIs) is a major public health problem, threatening the effective treatment of UTIs. This study investigated the phenotypic and molecular characteristics of associated with UTIs in Port-Harcourt, Nigeria.

METHODS

Twenty-five non-duplicate isolates of from UTIs patients at the University of Port-Harcourt Teaching Hospital, Nigeria were identified using Matrix-Assisted Laser Desorption Ionization Time-of-Flight (MALDI-TOF) Mass Spectrometry. The antimicrobial susceptibility patterns were determined using Kirby-Bauer disc diffusion technique. Phenotypic expression of Extended Spectrum Beta Lactamases (ESBLs) and AmpC beta-lactamase were determined using standard laboratory methods and polymerase chain reaction (PCR) was used to detect ESBLs, AmpC, Quinolones and Aminoglycosides resistance genes.

RESULTS

The isolates exhibited high rates of resistance to co-trimoxazole (76%), nalidixic acid (68%), ciprofloxacin (60%), gentamicin (44%) and low resistance to cefotaxime (20%) but were fully susceptible to cefoperazone/sulbactam, amikacin, nitrofurantoin, colistin and carbapenems. Phenotypic expression of ESBLs was recorded in 6(24%) isolates while genotypic detection revealed the highest prevalence of TEM 22(88%), followed by CTX-M-15 16(64%), blaSHV 7(28%) and OXA-1 6(24%) while AmpC (CMY-2) gene was detected in 8(32%) isolates. Amongst the quinolone resistant isolates, variants (, and ) and genes were detected in 7(28%) and 3(12%) isolates respectively while all gentamicin resistant isolates possessed the gene. The co-expression of CTX-M-15 with quinolones and aminoglycoside genes were 20% and 40% respectively. The prevalence of multiple drug resistance was 52%.

CONCLUSION

A high proportion of the studied isolates co-expressed ESBLs, quinolones and aminoglycosides resistance genes which call for prompt antibiotic stewardship and preventive strategies to limit the spread of these genes.