The Prevalence of Extended Spectrum Beta Lactamase Producing Citrrobacter Freundii and Pprovidencia Stuartii from Medical Laboratories in Parts of Lagos State, Nigeria
Article Sidebar
Main Article Content
Abstract
Citrobacter freundii and Providencia stuartii are members of the family Enterobacteriaceae which are emerging as important Extended Spectrum Beta Lactamase (ESBL) producing pathogens. This study was aimed to determine the prevalence of ESBL and carbapenemase production in C. freundii and P. stuartii. from laboratories in the northwest of Lagos. A total of 134 isolates were obtained from laboratories. Isolate identification, antibiotics susceptibility testing, and phenotypic detection of ESBL production were done using standardized procedures. Multiplex polymerase chain reaction (PCR) was performed on ESBL producing isolates to detect blaTEM, blaSHV, blaCTX-M, blaKPC, blaVIM, blaIMP and blaOXA. Out of 134 isolates 15 (11.2%) were Citrobacter freundii and only 2 (1.5%) were of the Providencia genus both of which were Providencia rettgeri and Providencia stuartii. A total of 9 (60%) tested positive for the production of Extended Spectrum Beta Lactamase (ESBL) enzyme while only Providencia stuartii of the Providencia genus also produced ESBL. Also, 8 (47%) of the initial Citrobacter and Providencia isolates produced carbapenemase Molecular characterization showed that 4 (44.4%) and 1 (100%) of the Citrobacter freundii and Providencia stuartii isolates respectively, displayed the presence of CTX-M gene while 2 (20%) of all ESBL producing isolates also possessed SHV gene including 1 (11.1%) of ESBL producing Citrobacter freundii and 1 (100%) of ESBL producing Providencia stuartii.
Antibiotic susceptibility testing showed that Citrobacter freundii displayed the highest resistance to Ceftazidime and Cefotaxime at 71.4% and the least resistance to Amoxicillin-Clavulanate at 28.6%. Providencia stuartii also displayed absolute resistance (100%), to cefotaxime and ciprofloxacin and absolute susceptibility (100%) to Ceftazidime. Also, Citrobacter freundii showed the same resistance patterns with 57.1% resistance to Gentamicin, Cefuroxime and Ceftriaxone antibiotics while Providencia stuartii showed varied resistance patterns with absolute resistance (100%), absolute susceptibility (100%) and absolute resistance (100%) to Gentamicin, Cefuroxime and Ceftriaxone antibiotics respectively. In conclusion, the Multiple Antibiotic Resistance Index values of both bacterial genera showed that 70.6% were from High-Risk sources indicating that the majority of bacteria analysed were from environments where they have been subjected to a high burden of antibiotic exposure.
Article Details
Authors hold the copyright of all published articles except otherwise stated.
References
Adzitey F. (2015). Antibiotic classes and antibiotic susceptibility from selected poultry: a mini review. World's Veterinary Journal 5(3): 36-41.
https://doi.org/10.5455/wvj.20150853
Albiger B., Glasner C., Struelens M., Grundmann H., Monnet D., European Survey of Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) working group. Carbapenemase-producing enterobacteriaceae in europe: assessment by national experts from 38 countries. Euroroundup pp. 1-15.
Ambler R. 1980. The structure of beta lactamases Philos. Trans. R. Soc. Lond. B. Biol. Sci. 289(1036): 321-331
https://doi.org/10.1098/rstb.1980.0049
Asensio, A., Oliver, A. and Gonzolez-Diego P, (2000): Outbreake of a multiresistance Klebsiella pneumoniae strains in an intensive care unit: antibiotics use as risk factor for colonization and infection. Clinical Infectious Disease 30:55-60.
https://doi.org/10.1086/313590
Ashish K., Nachtar S., Aruna A. and Menka K. (2012). The antibiotic resistance pattern in Citrobacter Species: an emerging nosocomial pathogen in a tertiary care hospital. Journal of Clinical and Diagnostic Research 6(4): 642-644
Bauer A, Kirby W, Sherris J and Turck M. (1966). Antibiotic Susceptibility testing by a standardized single disk method. Am. J. Clin. Pathol. 45(4): 493-496
https://doi.org/10.1093/ajcp/45.4_ts.493
Bonnet, R. (2004): Growing group of extended -spectrum beta-lactamases: the CTX-M enzyme. Antimicrobial Agent and chemotherapy 48 (3): 1-14.
https://doi.org/10.1128/AAC.48.1.1-14.2004
Bradford, P.A. (2001): Extended-spectrum beta-lactamases in the 21st century: characterization, epidemiology, and detection of this important resistance threat. Clinical Microbiol Rev 14(4):933-51.
https://doi.org/10.1128/CMR.14.4.933-951.2001
Bush, K. (2001): New beta-lactamases in gram-negative bacteria: diversity and impact on the selection of antimicrobial therapy. Clinical Infectious Diseases 32 (7):1085-9.
https://doi.org/10.1086/319610
Calderon C. and Sabundayo B. (2007). Antimicrobial Classifications: drugs for bugs. Antimicrobial Susceptibility Testing Protocols.
https://doi.org/10.1201/9781420014495.ch2
Chandra, Parul B., Archana Y., Babita P., Abhay M., and Anant R. (2017). Antimicrobial resistance and the alternative resources with special emphasis on plant-based antimicrobials-a review. Plants 6(16): 1-11.
https://doi.org/10.3390/plants6020016
Clinical and Laboratory Standards Institute (formerly NCCLS) (2000): Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically. Approved standard M7-A5 and informational supplement M100 S10. National Committee for Clinical Laboratory Standards, Wayne, Pa.
Coico R. (2005). Gram staining. Curr. Protoc. Microbiol. Appendix 3.
https://doi.org/10.1002/9780471729259.mca03cs00
Downing, T., Imamura, H., Decuypere, S., Clark, T.G., Coombs, G.H., Cotton, J.A. (2011): Whole genome sequencing of multiple Leishmania donovani clinical isolates provides insights into population structure and mechanisms of drug resistance. Genome Res. 21: 2143-2156.
https://doi.org/10.1101/gr.123430.111
Gaibani P., Ambretti S., Berlingeri A., Gelsomino F., Bielli A., Landini M. and Sambri V. (2011). Rapid increase of carbapenemase producing Klebsiella pneumoniae strains in a large Italian hospital. Euro Surveillance 16(8): 1-3.
https://doi.org/10.2807/ese.16.08.19800-en
Gisele, P., Jasminse, A., Neil W., and Johann D. (2011): New delhi metallo beta lactamases from travelers retuning to Canada. Emerging Infectious Diseases 17(2) 242-244.
https://doi.org/10.3201/eid1702.101313
Gniadkowski, M. (2008). Evolution of extended-spectrum beta-lactamases by mutation Clinical Microbiology & Infection 14: 11-32.
https://doi.org/10.1111/j.1469-0691.2007.01854.x
Jacoby, G. A and Medeiros, A.A. (1991): More extended-spectrum beta-lactamases. Antimicrob. Agents Chemother. 35:1697-1704.
https://doi.org/10.1128/AAC.35.9.1697
Karah N., Haldorsen B., Hegstad K., Simonsen G., and Sundsfjord A. (2011). Species identification and molecular characterization of Acinetobacter spp. blood culture isolates from Norway. J Antimicrob Chemother. 66(4):738-744.
https://doi.org/10.1093/jac/dkq521
Kariuki S. and Dougan G. (2014). Antibacterial resistance in sub-saharan africa: an underestimated emergency. Annals of the New York Academy of Sciences 1323(1): 43-55.
https://doi.org/10.1111/nyas.12380
Kenneley I. (2013). A microbiological overview of carbapenem-resistant enterobacteriaceae. Prevention strategist pp. 30-33.
Kotra, L., Samama, J and Mobashery S. (2002): Beta-lactamases and resistance to beta- lactam antibiotics. In Bacterial Resistance to Antimicrobials, Lewis K, Salyers A.A, Tabar H.W, Wax R.G (eds). Marcel Decker: New York; 123-160.