A STUDY AND MOLECULAR DETECTION OF ANTIBIOTICS RESISTANT GENES INGRAM NEGATIVE UROPATHOGENS AMONGPATIENTS WITHSUSPECTED URINARY TRACT INFECTION IN KANO STATE, NIGERIA

Abstract

Urinary tract infection is caused mostly by different bacteria of family Enterobacteriaceae in hospital and communities acquired infection. Emerging increasing resistance has been observed among uropathogens. The aim of the research is to evaluate current antibiotic resistance pattern of gram negative bacteria causing UTI among patients attending three reference hospitals in Kano, Nigeria. This research was conducted at Aminu Kano teaching hospital, Kano State, Nigeria. Three hundred and eighty four urine samples (384) of patients who were suspected of UTI were included as the study population. The urine sample was inoculated on cysteine lactose electrolyte deficient (CLED) agar plates and incubated at 37^oc for 24 hours. Identification was based on standard microbiological methods. The susceptibility testing was done by modified Kirby Bauer technique. CLSI 2024 guidelines were used for screening and confirmation of ESBL production. Double disk synergy method was used for confirmation of ESBL.Out the 384 urine samples processed, 111 isolates were obtained,E coliwas 32 (30.6%), Citrobacter spp 22 (19.8%), Klebsiella pneumoniae 17 (15.3%), K. oxytoca11 (9.9%), Enterobacter 9 (8.1%), Pseudomonas aeruginosa4 (3.6%), Acinetobacter baumanni3 (2.7%), Proteus vulgaris 6 (5,4%), Yersinia spp 5 (4.5%). Susceptibility showed that the isolates were highly susceptible to gentamycin (86.04%) and nitrofuratoin (67.5%). Resistance to third generation cephalosporins varies from 48.84% - 75.2%, while amoxicillin has 72.1% resistance. Among the isolates 19 were ESBL producers. Prevalence of ESBL was 35.3% for E. coli, 28.6% for K. pneumonia, 12.5% for citrobacter spp.The isolates were also screened for antibiotic susceptibility to meropenem and imipenem in order to determine suspected carbapenemase producing isolates. Isolates with zone of inhibition to meropenem and imipenem measuring <19mm were subjected to confirmatory test using Modified Hodge Test.Result shows that only 53.3% of the isolates were susceptible to meropenem and 50% were susceptible to imipenem , while 36.6% and 36.7% were resistant to meropenem and imipenem respectively. It is recommended for continuous surveillance of resistant rate among bacterial isolates causing UTI to ensure proper recommendation for the treatment of the disease.