Multidrug resistance profile and extended-spectrum beta-lactamase production in faecal escherichia coli isolated from hiv and tb patients in Ekiti-State, Nigeria

Abstract

With the increasing use of antibiotics and widespread of antibiotics resistance which has been amplified by the production of ESBLs in clinical isolates; the study was to determine the multidrug resistance Profile and Extended-spectrum Beta-lactamase production in faecal Escherichia coli isolated from HIV and TB Patients in Ekiti-State, Nigeria. Three hundred isolates of E. coli were obtained from the stool samples of HIV/AIDS patients, TB patients and apparently healthy individuals. The sample was cultured on Eosin-Methylene Blue (EMB) agar plate and incubated at 37ºC for 24 hours. The colony showing greenish metallic sheen was identified using the conventional biochemical. Antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion technique. Bacteria showing resistance to at least three different classes of antibiotics were considered multidrug resistant (MDR). Extended spectrum beta-lactamase production was detected by combined disc method using ceftriaxone/cefotaxime and Amoxicillin/clavulanic acid discs.A total of 141(47%) males and 159(53%) female patients were involved in the study. Based on the age distribution, age group 30-39(n=80) has the highest percentage while age group 60 and above (29) has the lowest participation among the age groups. E. coli isolated from HIV/TB co-infected reveals 40(80%), 26(52%), 21(42%) and 37(82%) resistant to SXT, AMC, SAM and AZM respectively while 24(48%), 36(72%), 23(46%) and 26(52%) of E. coli isolated from HIV patients on treatment were resistant to SXT, AMC, SAM and AZM. Tuberculosis patients on anti- TB treatment had 45(90%), 34(68%), 36(72%) and 44(88%) of the isolates resistant to SXT, AMC, SAM and AZM respectively while E. coli isolated from newly diagnosed HIV patients were 31(62%), 29(58%), 15(30%) and 27(54%) of the E. coli were resistant to SXT, AMC, SAM and AZM. Similarly, 33(66%), 36(72%), 15(30%) and 39(78%) of the isolated E. coli from newly diagnosed TB patients showed resistance to SXT, AMC, SAM and AZM respectively. Among the 148 multiple antibiotic resistant E. coli isolates 38 (23.75%) were found to be Extended β-lactamase (EBLS) positive with majority of the positive EBSL E. coli isolate from TB and TB associated patients. The increase in the prevalence of ESBL among faecal E. coli, an indicator organism for enteric pathogens, however, express the urgent need for serious antibiotics stewardship and control among clinicians and other health personnel especially in developing and under developed countries for proper management of the immune impaired individuals.