Multidrug Resistant Profile of Uropathogenic Escherichia coli (UPEC) Isolated from Diabetic Patients in Some Hospitals of Bauchi Metropolis, Nigeria

Abstract

Background: Urinary Tract Infection (UTI) is a common pathogenic inflammatory, distressing and occasionally life-threatening condition that affects people of all ages and genders, with difficulty in treatment due to the high rate of antibiotic resistance. Escherichia coli is the primary cause of UTIs in humans both in diabetic and non-diabetic patients. Diabetic patients are more prone to urinary tract infection due to their immunocompromised system and hyperglycemia level compared to non- diabetic patients. Antibiotics are becoming less and less effective, therefore there is an urgent need to curtail this problem in order to have good administration of antibiotics to patients for effective treatment. Aim: To determine the multidrug resistance profile of uropathogenic Escherichia coli (UPEC) isolated from diabetic patients in some hospitals of Bauchi metropolis, Nigeria Methods: A total of 288 study participants were enrolled in the study, (194 diabetic and 94 non- diabetic patients). Clean catch mid-stream urine samples were collected from all the participants in sterile containers. Each urine sample was streaked onto CLED (cysteine lactose electrolyte deficient) agar, incubated at 370C for 24hours and the isolates were identified using standard methods. Data obtained were analyzed statistically. Results: A total of 64 UPEC were isolated from diabetic patients and 35 UPEC was isolated from non-diabetic patients. The age group of 31-40 had high frequency of occurrence in both the study participants, 18(28.1) in DM and 9(25.7) in NDM patients. While age group of 10-20 had 5(7.8) in DM and 2(5.7) in NDM patients and ≥ 71 years 2(3.1) in DM and 1(2.9) in NDM patients had the least. There was no significant difference between age group and the number of isolates as p> 0.05. Highest frequency of UPEC was found within the female 36(56.3) in DM and 20(57.1) in NDM patients than their male counterparts 28(43.8) in DM and 1(2.9). Type2 patients have high frequency of isolates compared to the Type 1 patients in Both the study participants. In the present study, 52 UPEC isolates from diabetic patients and 27 UPEC isolates from non-diabetic patients were resistant to 1 drug in 3 or more antimicrobial agents classes (multidrug resistance). The highest resistance was observed against ampicillin and piperacillin-tazobactams, while the least resistance was in imipenem. Conclusion: The study established that UPEC infection was more prevalent in diabetic than non-diabetic patients, and also more prevalent in the middle age group, female gender and Type2 diabetic patients. A high rate of multidrug resistance was observed in both the study participants, and this signals a tremendous problem in prescription of antibiotics to patients. The emergence of multi resistant strains of UPEC has added to the need for urgent development of more control measures and policies on the use of antibiotics.