Antibiotic resistance characterization and detection of BLAIMP gene among uropathogenic Escherichia coli and klebsiella pneumoniae isolates in Okada, Edo State, Nigeria

Antibiotic resistance is a major public health issue worldwide and became one of the principal international healthcare crises of the 21st century. The production of MBL is one of the resistance mechanisms in Enterobacteriaceae, and they are increasingly detected in Escherichia coli and Klebsiella pneumoniae globally. Therefore, the aim of this study was to determine the phenotypic and molecular characteristics of MBL-producing E. coli and K. pneumoniae among Okada patients in IUTH with UTIs. A total of 300 urine samples were obtained from Igbinedion Univeristy Teaching Hospital in Okada between January 2022 to December 2023. E. coli and K. pneumoniae isolates were culturally and biochemically identified. Antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion technique. Metallo beta-lactamase production was detected by combined disc assay using meropenem and meropenem/EDTA discs. Bacteria showing resistance to at least three different classes of antibiotics were considered multidrug resistant (MDR). In order to spot blaIMP), polymerase chain reaction was conducted. Of the total 300 urine samples processed, 93(31%) samples were culture positive, among which E. coli and K. pneumoniae samples were 75 (80.6%) and 18 (19.3%) respectively. Among the 75 E. coli and the18 K. pneumoniae, 67 (89.3%) E. coli and 18(100%) K. pneumoniae were multidrug resistant. The lowest rates of resistance were seen toward imipenem (5.3%) and meropenem (5.3%) followed by nitrofurantoin (60%) and ofloxacin (69%). Four of the 5 MBL phenotypically screen positive E. coli were PCR positive for blaIMP gene. The study showed high prevalence of drug-resistant genes harbored by the uropathogens. Imipenem and meropenem are the most effective drugs to treat ESBL producers. It is therefore recommended that antibiotic stewardship programs should be implemented immediately to combat antibiotic resistance.