Antibiogram Pattern of Multidrug Resistance of Gram-negative Extended Betalactamase Isolates from Urine of Diabetic Patients

Ifeanyi Onyema Oshim, Joy Imuetinya Ehiaghe, Oluwayemisi Odeyemi, A. A. Obroh, Evelyn Ukamaka Urama, Gabriel Okezie Chidiebere
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Abstract

Background: The rate of multidrug resistant bacteria is the most worrisome in the health setting because it often associates with nosocomial infection. Objectives: This present study aim at, evaluating the antibiotic pattern of multidrug resistance of Gram-negative extended betalactamase isolates from urine of diabetic patients. Methods: This is a cross sectional study carried out at Nnamdi Azikiwe University Teaching Hospital with a total of 110 diabetic patients and were recruited using convenient sample method. The patients were instructed on how to collect the mid-stream urine samples without contamination. The samples were cultured and characterized the isolates following standard bacteriological methods. The isolated bacteria were subjected to sensitivity test pattern using agar disc diffusion techniques. The multidrug resistant isolates were physically checked for the extended spectrum betalactamase production. Obtained data was subjected to these statistical tools; descriptive statistics, chi-square and pair-test using Statistical Package for the Social Science (SPSS version 26). Results: Out of 110 urine samples assessed for significant growth of bacteria, it was found that, 55(27%) were the Gram negative bacteria (GNB).The highest prevalence of isolates were E. coli 30(54.6%), followed by Klebsiella pneumonia 14 (25.5%), Pseudomonas aeruginosa 6 (10.9%), and Proteus species 5 (9.09%) respectively. The most occurrence of the MDR bacteria were found in Augmentin 46 (83.6%) as well as as Cefuroxime  43 (78.2%) respectively. The significant mean range of Augumentin and Cefixime resistant to ESBL producers were (0.53±1.2; p = 0.000) and (0.600 ± 0.974; p = 000) respectively. Conclusion: The study detected the high proportion of multi-drug resistant isolates and the most occurrence were found in E. coli and Klebsiella pneumoniae. Regular monitoring, conducting, supervising, or management of antibiotics and molecular biomarkers for drug resistance are paramount to curtail the rate of drug-resistant pathogens.
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糖尿病患者尿中革兰氏阴性延伸β -内酰胺酶多药耐药的抗菌谱分析
背景:多药耐药细菌的发病率是卫生环境中最令人担忧的,因为它通常与医院感染有关。目的:评价糖尿病患者尿中革兰氏阴性延伸β -乙酰胆碱酯酶的多药耐药模式。方法:采用横断面研究方法,在Nnamdi Azikiwe大学教学医院对110例糖尿病患者进行抽样调查。指导患者如何在没有污染的情况下收集中游尿液样本。采用标准细菌学方法对样品进行培养和鉴定。采用琼脂盘扩散技术对分离的细菌进行敏感性试验。对多重耐药菌株进行了广谱β -内酰胺酶生产的物理检查。获得的数据经过这些统计工具处理;描述性统计,卡方和配对检验使用统计软件包的社会科学(SPSS版本26)。结果:在110份尿液样本中评估了细菌的显著生长,发现55份(27%)为革兰氏阴性菌(GNB)。检出率最高的是大肠杆菌30(54.6%)、肺炎克雷伯菌14(25.5%)、铜绿假单胞菌6(10.9%)和变形杆菌5(9.09%)。耐多药细菌以Augmentin 46(83.6%)和头孢呋辛43(78.2%)最多。奥古司汀和头孢克肟对ESBL生产者的耐药显著平均范围为(0.53±1.2;P = 0.000)和(0.600±0.974;P = 000)。结论:本研究检出的多重耐药菌株比例较高,以大肠杆菌和肺炎克雷伯菌居多。定期监测、指导、监督或管理抗生素和耐药分子生物标志物对于降低耐药病原体的发生率至关重要。
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