Prevalence of Extended-spectrum Beta-lactamase Mediated Urinary Tract Infections in a Tertiary Hospital in Enugu, South East, Nigeria

Abstract

Extended-Spectrum Beta-Lactamase (ESBL) are a class of plasmid-mediated diverse, complex and rapidly evolving enzymes which hydrolyzes penicillins, monobactams and broad-spectrum cephalosporins. There is increasing prevalence of ESBL-producing bacteria globally with higher prevalence reported in developing countries. The present study was designed to determine the prevalence and antimicrobial sensitivity pattern of ESBL producing bacteria isolates in patients with Urinary Tract Infection (UTI) in Enugu. Urine samples were collected from a total of 284 subjects with self-reported UTI In the Enugu State University of Science and Technology Teaching Hospital, Enugu State, Nigeria between the periods of April to May,2019.Samples were analyzed for the presence of UTI and antimicrobial resistance pattern of ESBL-producing bacteria using standard methods.  Data was analyzed by descriptive statistics using SPSS version 23 (IBM Corp Armok, NY). A total of 145 strains of Staphylococcus aureus (n= 19). Escherichia coli (n=52), Klebsiella pneumonia (n=45), Pseudomonas aeruginosa (n =12), Enterococcus faecalis (n=9) and Proteus mirabilis (n=8), were isolated from 132 subjects giving a UTI prevalence rate of 34.6%.  Forty-nine (49) ESBL-producing strains comprising Staphylococcus aureus (n=5), Escherichia coli (n=15), Klebsiella pneumonia (n=16), Pseudomonas aeruginosa (n=13), Enterococcus faecalis (n=8) and Proteus mirabilis (n=7) were implicated in UTI accounting for 46.8%ESBL-producing bacteria mediated UTI.  There is a high prevalence of ESBL-producing bacteria induced UTI. This portends a great danger to the management of bacterial infections.