Keywords
Antibiotic resistance
Multiple antibiotic resistance index
Extended-spectrum β-lactamase
Article Number
047Abstract
Diarrhoea remains a major public health challenge worldwide, particularly in developing countries where poor sanitation, unsafe water and inadequate hygiene contribute significantly to disease transmission. The increasing emergence of antimicrobial-resistant enteric bacteria, especially extended-spectrum β-Lactamase (ESBL) producing organisms, has complicated the treatment and management of diarrhoeal infections. This study aimed to evaluate the occurrence of ESBL-production among antibiotic-resistant bacterial isolates obtained from diarrhoeic patients. A total of 367 stool samples were collected from patients attending selected hospitals in Akure, Ondo State, Nigeria, comprising 17 diarrhoeic and 350 non-diarrhoeic samples. Standard microbiological techniques were employed for the isolation and identification of bacterial pathogens, while antibiotic susceptibility testing was performed using standard antimicrobial sensitivity methods. ESBL production was phenotypically detected using appropriate confirmatory methods on multidrug-resistant bacterial isolates. The study identified several enteric bacterial pathogens associated with diarrhoeal infections, including Escherichia coli, Proteus mirabili and the species of Salmonella, Shigella, Klebsiella and Enterobacter. Antibiotic susceptibility testing revealed varying degrees of resistance to commonly used antibiotics, with several isolates demonstrating multidrug resistance. 6.7% of isolates were resistant to ofloxacin, 37.8 % to augmentine, 18.9% to peflacine, 45.9% to ceftazidime, 13.5% to gentamycin, 59.46% to ciprofloxacin, 17.5% to ceporex, 40.5% to ceftriaxone, 9.4% to streptomycin and 32.4% to cefuroxime. ESBL-producing isolates were detected among the bacterial pathogens, suggesting the circulation of resistant enteric bacteria within the study population. The findings of this study highlight the growing threat of ESBL-producing enteric bacteria in diarrhoea diseases and emphasize the need for continuous surveillance, effective infection prevention measures and rational antibiotic use to reduce the spread of antimicrobial resistance.References
Bush, K., and Bradford, P. A. (2020). Epidemiology of β-lactamase-producing pathogens. Clinical Microbiology Reviews, 33(2): e00047-19.
Cheesbrough, M. (2010). District Laboratory Practice in Tropical Countries (2nd ed.). Cambridge University Press.
Clinical and Laboratory Standards Institute (CLSI). 2020. Performance Standards for Antimicrobial Susceptibility Testing. 30th ed. CLSI Supplement M100. Wayne, PA: Clinical and Laboratory Standards Institute.
Cochran, W. G. (1977). Sampling techniques (3rd ed.). John Wiley & Sons. The 1977 third edition, Wiley publication, ISBN 978-0-471-16240-7.
Fawole, M. O., and Oso, B. A. (2007). Laboratory Manual of Microbiology (5th ed.). Ibadan: Spectrum Books Ltd.
Garrity, G. M. (Ed.). (2001–2012). Bergey’s Manual of Systematic Bacteriology (2nd ed., Vols. 1–5). Springer
Logan, L. K., and Weinstein, R. A. (2021). The epidemiology of carbapenem-resistant Enterobacteriaceae: The impact and evolution of a global menace. Journal of Infectious Diseases, 223(Supplement_3): S151–S162.
Murray, C. J. L., Ikuta, K. S., Sharara, F., Swetschinski, L., Robles Aguilar, G., Gray, A., Han,C., Bisignano, C., Rao, P., Wool, E., Johnson, S. C., Browne, A. J., Chipeta, M. G., Fell, F., Hackett, S., Haines-Woodhouse, G., Kashef Hamadani, B. H., Kumaran, E. A. P., McManigal, B., and Naghavi, M. (2022). Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis. The Lancet, 399(10325): 629–655.
Musa, B. M., Imam, H., Lendel, A., Abdulkadir, I., Gumi, H. S., Aliyu, M. H., & Habib, A. G. (2020). The burden of extended-spectrum β-lactamase-producing Enterobacteriaceae in Nigeria: A systematic review and meta-analysis. Oxford University Press Transactions of the Royal Society of Tropical Medicine and Hygiene, 114(4), 241–248.
Odonkor, S. T., and Addo, K. K. (2021). Enteric bacterial pathogens associated with diarrhoeal disease: prevalence and antimicrobial resistance. BMC Infectious Diseases, 21, 1186.
Paterson, D. L and Bonomo, R. A. (2005). Extended-spectrum β-lactamases: a clinical update. Clinical Microbiology Reviews, 18(4): 657-686.
Salihu M. K., Yarima A., and Atta H.I. (2020) Methods for the phenotypic detection of extended -spectrum beta-lactamase (ESBL) producing bacteria. Nigeria Journal of Biotechnology 37(2): 113–125.
Tadesse, S., Mulu, W., Genet, C., Kibret, M., and Belete, M. A. (2022). Emergence of high prevalence of extended-spectrum beta-lactamase and carbapenemase-producing Enterobacteriaceae species among patients in Northwestern Ethiopia Region. BioMed Research International, 2022: 1–9.
Tooke, C. L., Hinchliffe, P., Bragginton, E. C., Warriner, P., Morgan, L. M. C., and Spencer, J. (2021). β-lactamases and β-lactamase inhibitors in the 21st century. Journal of Molecular Biology, 433(2): 166821.
World Health Organization (WHO) (2024). WHO bacterial priority pathogens list 2024: bacterial pathogens of public health concern to guide research, development and strategies to prevent and control antimicrobial resistance. World Health Organization.
World Health Organization (WHO). (2021). Global antimicrobial resistance and use surveillance system (GLASS) report 2021. Geneva, Switzerland: World Health Organization.
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