Detection of Extended Spectrum Beta-lactamase Gene (CTX-M) among Representative Multidrug-Resistant Gram Negative Bacterial Isolates from Patients with Urinary Tract Infection in Ekiti State, Nigeria

Urinary tract infection is huge public health burden and the emergence of extended spectrum beta lactamase producing bacterial pathogens increases the burden of infectious diseases in Nigeria. This study determined the current prevalence of cephalosporin resistance among Gram-negative bacteria isolated from patients with urinary tract infections between February 2018 and June 2018. Non-repetitive Gram–negative bacteria were recovered from 106 individuals with urinary tract infections who reported at two tertiary healthcare centers in Ekiti-State, Nigeria. A total of 106 bacterial isolates were obtained which included: Klebsiella pneumoniae 34 (29.1%), Klebsiella oxytoca 17 (16.0%), Proteus vulgaris 10 (9.4%), E. coli 24 (22.6%), Proteus mirabilis 18 (16.9%) and Pseudomonas aeruginosa 3 (2.8%). Sixty five of these organisms showed resistance to ceftazidime while 76 organisms showed resistance to ceftriaxone. Forty representative organisms were selected and tested for presence of extended spectrum beta-lactamase (ESBL) genes using primers specific for different ESBL genes. A total of eight (20.0%) organisms carried the blaCTX-M gene and other variants of the ESBL genes were not detected. The organisms carrying the blaCTX-M gene included E. coli 3 (37.5%), K. pneumoniae 1(12.5%), P. mirabilis 1(12.5%),) and K. oxytoca 3(37.5%). The high prevalence of cephalosporin resistant Gram-negative bacteria among patients with UTI is a serious threat to public health and efforts must be intensified to regulate the clinical use of the cephalosporins.