Extended spectrum beta-lactamase-producing bacteria among diabetic patients with asymptomatic bacteriuria in a secondary health facility in Edo State, Nigeria

ABSTRACT

Asymptomatic bacteriuria (ASB) can increase the risk for developing symptomatic urinary tract infection (UTI) and diabetes mellitus is one of the high risk medical condition for ASB. This study was carried out to determine the prevalence of extended spectrum beta-lactamase (ESBL)-producing bacteria in diabetic patients attending Central Hospital, Benin City. The descriptive cross-sectional study design was adopted for this study, while data was obtained with the use of a structured questionnaire administered on 695 consented diabetic patients. Statistical analysis was done using the statistical software INSTAT� (Graph Pad Software Inc., La Jolla, CA, USA). Mid-stream urine samples were aseptically collected from these patients, processed and analysed using standard techniques. Identification of bacterial isolates and antimicrobial susceptibility testing were carried out using standard microbiological techniques. ESBL-producers were detected using appropriate phenotypic method. A total of 253(36.4%) patients were culture positive with Escherichia coli being the most predominant organism (37.5%). Proteus mirabilis was the highest ESBL producer and was statistically significant (50.0%) (p=0.0095). Uncontrolled glycaemia was associated with ESBL-production among bacterial isolates (P=0.0129). Age, gender and source of clinical isolates did not significantly affect ESBL production by the isolated uropathogenic bacteria (P >0.05).The prevalence of ESBL-producing bacteria among diabetic patients having ASB was 36.8%. Adherence to proper and effective antimicrobial regimen and laboratory guidance in treatment of ASB among diabetic patients are recommended