ANTIBIOTICRESISTANCE IN FAECAL ESCHERICHIA COLI AMONG UNDERGRADUATE STUDENTS OF OBAFEMI AWOLOWO UNIVERSITY, ILE-IFE
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Date
2017
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Abstract
The study isolated and identified faecalEscherichia coli from undergraduate students, determined the resistance pattern of the isolates, ascertained the production of extended spectrum beta lactamases (ESBL) and carbapenemase by the isolates and identified the possible risk factor that predispose to the carriage of drug- resistant organisms.These were with a view to determining burden of antibacterial resistance as a basis for resistance control.
The cross-sectionalstudy was approved by the Ethics and Research Committee of the Institute of Public Health,ObafemiAwolowo University, Ile-Ife,and the study was conducted at the Medical Microbiology Laboratory, Department of Medical Microbiology and Parasitology, ObafemiAwolowoUniversity. Two hundred faecal samples were collected from volunteer fresh students who have not been on antibiotics within the 30 days prior to sample collection and inoculated onto eosin methylene blue agar plates(EMB). Up to five discrete colonies with green metallic sheen, typical of E. coli were picked and streaked onto nutrient agar plates and incubated at 37o C for 24 hours. Identification was carried out by microscopy and conventional biochemical tests. The Kirby-Bauer disc diffusion test was used for the antimicrobial susceptibility testing for all the isolates using 11 antibiotics and interpreted according to Clinical and Laboratory Standards Institute (CLSI) guidelines of 2014. All isolates resistant to third generation cephalosporin were tested for ESBL production by using the combined disc diffusion technique, involving the use of clavunate combinations of the third-generation cephalosporinscefotaxime and ceftazidimeaccording to the CLSI guidelines. All isolates resistant to meropenem were screened for bothKlebsiellapnuemoniaecarbapenemases and metallobeta-lactamases using modified Hodge test and combination synergy disk respectively. Molecular detection of ESBL encoding genes (bla TEM, bla SHV, and bla CTX-M)and carbapenemase encoding genes (bla NDM, bla KPCand bla VIM)weredone using polymerase chain reaction. Risk factors which include demographic details, self-medication behaviour, hygiene, previous exposure to antibiotics and source of drinking water were analysed for association with carriage of multidrug resistant organisms. Data generated was analysed using descriptive and inferential statistics.
A total of 350 E. coli were isolated from 186 subjects, distributed as 100 females and 86 males. Rates of resistance in isolates ranged from 2.8% (n=10) for meropenem to 90.6% (n=317) for tetracycline. The percentage of isolates resistant to at least six drugs is 32.5%. Twenty (33%) of the 60 isolates resistant to third generation cephalosporinswere found to be ESBLs producersphenotypically and only 18 (30%) were positive to genotypic screening of the tested genes (bla TEM, bla SHV, and bla CTX-M). Phenotypically, five of 10 meropenem-resistant isolates were carbapenemase- producing. Self-treatment (χ2=4.505; p= 0.034), knowledge about causes of antibiotic resistance (χ2=4.791;p= 0.029) and previous exposure to antibiotics (χ2= 3.898;p= 0.048) were found to be associated with carriage of multidrug resistance.Self-treatment (χ2= 4.382; p= 0.036) and source of drinking water (χ2= 9.571; p= 0.008) were found to be associated with carriage of ESBL producing isolates.
In conclusion, the rate of antibiotic resistance is high showing the unrelenting effort of microorganism at developing resistance to commonly used antibiotics.
Description
xiv, 102p
Keywords
Anticbioticresistance, faecal Escherichia, spectrum beta lactamases (ESBL), carbapenemase, the combined disc diffusion technique