Detection of Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae Isolates from Children with Gastrointestinal infection in Ilorin, Kwara state

Abstract

The emergence of antimicrobial resistance (AMR) is considered one of the most significant public health challenges of the 21^st century, posing serious risks to the effective treatment of infections, and threatening to undo decades of medical progress. This study aims to investigate the phenotypic patterns of extended spectrum beta- lactamases (ESBL) producing Enterobacteriaceae in isolates obtained from two hospitals in Ilorin. A total of eighty- four non- duplicate stool samples were collected from children who had gastroenteritis. Bacterial isolation was carried out following standard laboratory procedures, and presumptive Gram-negative bacilli were stored on nutrient agar slants at 4ºC until needed. Forty (40) presumptive gram- negative bacterial isolates were sub-cultured, purified, and identified using Microbact 12E identification kit. Isolates were screened for antibiotic susceptibility using the Kirby-Bauer disc diffusion method and thereafter screened for the production of ESBLs. Identified isolates include:  Klebsiella spp. (16), Acinetobacter spp. (3), Enterobacter spp. (9), Citrobacter spp. (2), Morganella spp. (1), Providencia spp. (1), Yersinia spp. (1), Serratia spp. (6), and Proteus spp. (1). Imipenem showed  the highest activity against the Enterobacteriaceae isolates by  92.5% followed by gentamicin, ciprofloxacin , ceftazidime, then sulphamethoxazole/ trimethoprim, amoxicillin clavulanate, tetracycline and amoxicillin had the least activity against the isolates by 17.5%.Twenty-one (21/40) multi-drug resistant Enterobacteriaceae isolates showing resistance to ≥ 3  antibiotics were identified, and 15 (71.43%) were phenotypically confirmed as ESBL producing Enterobacteriaceae with 10/15 (66.67%) being from Klebsiella spp, 26.67% belonging to the Enterobacter specie and 6.67% belonging to Serratia specie. A moderately high rate (37.50%) of ESBL producers were identified among the Enterobacteriaceae isolates screened. This study has revealed that there is a rising antibiotic resistance and increasing prevalence of ESBLs among the Enterobacteriaceae family, which is of public health concern. There is therefore the need for control strategies to be implemented in our hospital and community settings.