Detection of Extended Spectrum Beta Lactamase Producing Enterobacteriaceae from Tuberculosis Patients

Abstract

Antimicrobial drug resistance is a global issue that affects health, economic, and social development. This study therefore set out to determine the prevalence of extended-spectrum beta-lactamases (ESBLs) in bacteria isolated from tuberculosis patients in three selected hospitals in Ghana. A total of 53 isolates consisting of 36 Escherichia coli, 6 Klebsiella pneumoniae, 3 Enterobacter cloacae, 3 Morganella morganii, 1 Citrobacter freundi, 1 Enterobacter asburiae, 1 Klebsiella varicola ,1 Proteus mirabilis and 1 Serraatia marcescens were obtained from rectal samples and tested for their susceptibility to seventeen (17) commonly (due to easy accessibility and affordability) used antibiotics at the selected hospitals, ESBL production was determined by double disc synergy test and the ESBL genotypes were determined by PCR. A greater proportion 83.4% of isolates were resistant to the beta lactam antibiotics ranging from 5.6% for meropenem and ertapenem to 83.4% for amoxicillin/clavulanate when tested against E. coli. All the other isolates showed 100% resistance to amoxicillin/clavulanate. Also, five (5) isolates showed 100% resistance to trimethoprim-sulphamethoxazole. All the isolates were susceptible to imipenem and dorepenem. All of K. pneumonia, E. cloacae and M. morganii were resistant to amoxicillin/clavulanate. ESBL phenotypes were detected in E. coli and E. cloacae. BlaTEM genotype was present in E. coli and K. pneumoniae. BlaSHV and BlaOXA-1 genotypes were also detected in K. pneumoniae and E. coli respectively. The overall ESBL prevalence was 15.1%. From the results, imipenem and doripenem will be the recommended drugs of choice. However, the use of amoxicillin/clavulanate and trimethoprim-sulphamethoxazole should be regulated.