Point-surveillance of antibiotic resistance in enterobacteriaceae isolates from patients in a Lagos teaching hospital, Nigeria

ABSTRACT

This study was carried out to determine a point prevalence of drug resistance and extended-spectrum Beta -lactamase [ESBL] among members of the family Enterobacteriaceae. Consecutive clinically significant non-repetitive isolates obtained from both hospitalized patients and outpatients' samples were studied. The isolates were identified using VITEK 2 while susceptibility testing was performed against 16 antibiotics using the E-test strips. Phenotypic production of ESBL was detected by E-test ESBL method. Positive isolates were confirmed by PCR. Of a total of 102 isolates studied, 43 [42.2%] were Escherichia coli and 32 [31.4%] Klebsiella pneumoniae. These isolates demonstrated remarkable high rates of resistance to the Beta -lactam antibiotics, except the carbapenems and piperacillin-tazobactam. Fifty-two [51%] were resistant to >/= 3 classes of drugs and 29 [28.4%] to >/= 5 drugs. Thirty-eight [37.3%] were ESBL producers. Of these, 21 [55.3%] were E. coli and 12 [31.6%] K. pneumoniae. Thus, the overall prevalence of ESBL-producing E. coli was 20.6% and K. pneumoniae 11.8%. This study showed an alarmingly high prevalence of antibiotic resistance in invasive Enterobacteriaceae isolates and a high prevalence of ESBL producers in the study center. Antibiotic stewardship and other preventive strategies are recommended to reduce the high rate of resistant bacteria in this hospital