Prevalence and multidrug-resistant ESBL-producing E. coli in urinary tract infection cases of HIV patients attending Federal Teaching Hospital, Abakaliki, Nigeria

Abstract

The study determined the frequency of extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-PEc) in HIV-infected individuals with urinary tract infections (UTIs) attending Federal Teaching Hospital Abakaliki (FETHA II), and the responses of these bacterial pathogens to colistin, cephalosporins, aminoglycosides, fluoroquinolones, and ertapenem. Exactly 200 urine samples (mid-stream) were collected from HIV-infected individuals. Standard microbiological techniques were used to characterize bacterial isolates. Phenotypic screening for the production of ESBLs was done by double disc synergy test. Antibiotic susceptibility study was carried out by the Kirby-Bauer disc diffusion technique. Results showed the presence of ESBL-PEc in the urine samples of HIV-infected individuals. ESBL-PEc were highly resistant to gentamycin (85%), ofloxacin (75%), ciprofloxacin (75%), nalidixic acid (70%), tobramycin (65%), kanamycin (64.3%), and norfloxacin (60%), but susceptible to ertapenem (60%) and amikacin (57.1%). The ESBL-PEc isolates were multidrug-resistant. Average multiple antibiotic resistance indices (MARI) value of isolates was 0.8, further depicting misuse/abuse of these antibiotic classes in our study area. Thus, it is pertinent to carry out antibiotic susceptibility testing before the commencement of antibiotic therapy, especially in HIV-positive patients with UTIs so as to attain effective treatment regimens and reduce the incidence of antibiotic resistance in healthcare settings.