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Background: Antibiotic resistance is a growing global healthcare challenge and efforts to contain it are being outpaced by rapid emergence of resistant microbes. Common environmental pathogens have been reported to be manifesting resistance to several antibiotics to which they were once sensitive. In hospital setting, close contact between patients and caregivers allow resistant strains to easily spread in hospital wards. Evidence of antibiotic resistance is needed to inform rational selection of drugs for infectious diseases.
Aim: The aims of this study were to determine common pathogenic bacterial isolates among patients and their antibiotic sensitivity profiles.
Methods: This was a cross sectional retrospective study using laboratory records of antibiotic resistance profiles of bacterial isolates obtained from patient medical samples. Antibiogram records for one year period were obtained and relevant data extracted for analysis
Results and Discussion: The most commonly isolated bacteria included Staphylococcus aureus, Escherichia coli and Klebsiella pneumoniae which together accounted for over two thirds of all isolates. Most of the isolates were resistant to at least four antibiotics; Penicillins, Sulphonamides and Tetracyclines exhibited the highest level of resistance. Resistance to these antibiotics is well reported in literature and their empirical prescription threatens their efficacy in the management of infectious diseases.
Conclusion: Antibiotic resistance among pathogenic bacteria was high, there is need to emphasize evidence based prescriptions to not only improve clinical outcomes but also to preserve the efficacy of current antibiotic stock.
World Health Organization. Antimicrobial resistance – Global report on surveillance. Geneva. Switzerland. WHO; 2014.
Frean J, Perovic O, Fensham V, McCarthy K, von Gottberg A, de Gouveia L et al. External quality assessment of national public health laboratories in Africa 2002 – 2009. Bull World Health Organization. 2012;90:191–191A.
Levy SR, Marshall B. Antibacterial resistance worldwide: Causes, challenges and responses. Nat Med. 2004;10(Suppl 12):S122–S129.
Lateef A. Antibiotics use and misused in developing countries. World J Microbiol. 2004;20:167– 170.
Nsofor CA, Iroegbu CU. Antibiotic resistance profile of Escherichia coli isolated from apparently healthy livestock in south eastern Nigeria. J Cell Animal Biol. 2012;6(6):2445–2450.
Ohi CA, Luther VP. Antimicrobial stewardship for inpatients facilities. J Hosp Med. 2011;6(Suppl 1):S4–S15.
Umar LH, Isah A, Musa S, Umar B. Prescribing pattern and antibiotic use for hospitalized children in a northern Nigerian teaching hospital. Ann Afr Med. 2018;17:26–32.
Eshiet UI, Effiong GS, Akwaowoh AE. The use of antibiotics in a Nigerian tertiary health care facility. Am J Biomed Sci Engineering. 2015;1(5):25–31.
Akinyandenu O, Akinyandenu A. Irrational use and non-prescription sale of antibiotics in Nigeria: A need for change. J Sci Innovative Res. 2014;3(2):251–257.
Oduyebo OO, Olayinka AT, Iregbu KC, Versporten A, Goossens H, Nwajiobi-Princewill PI, Jimoh O, Ige TO, Aigbe AI, Ola-Bello OI, Aboderin AO, Ogunsola FT. A point prevalence survey of antimicrobial prescribing in four Nigerian tertiary hospitals. Ann Trop Pathol. 2017;8:42–46.
Kourlaba G, Gkrania-Klotsas E, Kourkouni E, Mavrogeorgos G, Zaoutis TE. Antibiotic prescribing and expenditures in outpatient adults in Greece, 2010 – 2013: Evidence from real world practice. Euro Surveill. 2016;21(26):PII–302266.
Akram A, Megha R, Irfanul H, Pravina A, Rahul I, Dasari R, Kuriakose S, Patel I. Study the prescription pattern of antibiotics in the medicine department in a teaching hospital: A descriptive study. Int J Toxicol Pharmacol Res. 2014;6(4):43–46.
Kaur A, Bhagat R, Kaur N, Shafiq N, Gautam V, Malhotra S, Suri V, Bhalla A. A study of antibiotic prescription pattern in patients referred to tertiary care center in Northern India. Ther Adv Infect Dis. 2018;5(4):63–68.
Cui D, Liu X, Hawkey P, Li H, Wang Q, Mao Z, Sun J. Use of and microbial resistance to antibiotics in China: a path to reducing antimicrobial resistance. J Int Med Res. 2017;45(6): 1768–1778.
Oli AN, Okafor CI, Ibezim EC, Akujiobi CN, Onwunzo MC. The prevalence and bacteriology of asymptomatic bacteruria among antenatal patients in Nnamdi Azikiwe University teaching hospital Nnewi, South eastern Nigeria. Niger J Clin Pract. 2010;13:409–412.
Oladeinde BH, Omoregie B, Olley M, Anunibe JA. Urinary tract infection in a rural community of Nigeria. N Am J Med Sci. 2011;3:75–77.
Muoneke V, Ibekwe M, Ibekwe R. Childhood urinary tract infections in Abakiliki: Etiological organisms and antibiotic sensitivity pattern. Ann Med Health Sci Res. 2012;2:29–32.
Rabasa AI, Shattima D. Urinary tract infections in severely malnourished children at the University of Maiduguri teaching hospital. J trop Pediatr. 2002;48:359–361.
Okwori EE, Nwadioha SI, Jombo GTA, Nwokedi EOP, Odimayo MS. A comparative study of bacterial isolates from the urine samples of AIDS and non AIDS patients in Benue, Nigeria. Asian Pacific J Trop Med. 2010;3:382–385.
Mava Y, Bello M, Ambe JP, Zailani SB. Antimicrobial sensitivity pattern of organisms causing urinary tract infections in children with sickle cell anaemia in Maiduguri, Nigeria. Niger J Clin Pract. 2012;15:420–423.
Sire JM, Nabeth P, Perrier-Claude JD, Bahsoun I, Silby T, Macondo EA, et al. Antimicrobial resistance in outpatient Escherichia coli urinary isolates in Dakar – Senegal. J Infect Dev Ctries. 2007;1:263–268.
Stamm WE, Norby SR. Urinary tract infections: Disease panorama and challenges. J Infect Dis. 2001;183(Suppl 1):S1–S4.
Russo TA, Johnson JR. Medical and economic impact of extra-intestinal infections due to Escherichia coli: Focus on an increasing important endemic problem. Microbes Infect. 2003;5(5):449-456.
Dehbanipour R, Rastaghi S, Sedighi M, Maleki N, Faghri J. High prevalence of multidrug resistance uropathogenic Escherichia coli strain. Isfahan, Iran. J Nat Sci Biol Med. 2016;7(1):22–26.
Pitout JD, Laupland KB. Extended spectrum beta-lactamase producing Enterobacteriacea: An emerging public health concern. Lancet Infect Dis. 2008;3(3):159–166.
Urban C, Mariano N, Bradford PA, Tuckman M, Segal-Maurers JR, et al. Identification of CTX-M- beta-lactamases in Escherichia coli from hospitalized patients and residents of long term care facilities. Diagn Microbiol Infect Dis. 2010;66(4):402–406.
Amabile–Cuevas CF, Arredondo–Garcia JL, Cruz A, Rosas I. Fluoroquinolone resistance in clinical and environmental isolates of Escherichia coli in Mexico City. J Appl Microbiol. 2010;168(1):158–162.
Silva-Sanchez J, Cruz-Trujillo E, Barrios H, Reyna-Flores F, Sanchez-Perez A, Garcia-Ramos U. Characterization of plasmid mediated quinolone resistance [PMQR] gene in extended spectrum beta-lactamase producing Enterobacteriacea in pediatric clinical isolates in Mexico. Plos One. 2013;8(10):e77968.
Paniagua-Contreras GL, Monroy-Perez E, Rodriguez-Moctezuma JR, Dominguez-Trejo P, Vaca-Paniagua F, Vaca S. Virulence factors, antibiotic resistance phenotypes and O sero-groups of Escherichia coli strains isolated from community acquired urinary tract infection patients in Mexico. J Microbiol Immunol Infect. 2017;50(4):478–485.
Center for disease dynamics, economics and policy. State of the world’s antibiotics 2015. Washington DC; 2015.
Robicsek A, Beaumont JL, Paule SM, et al. Universal surveillance for Methicillin resistant Staphylococcus aureus in 3 affiliated hospitals. Ann Intern Med. 2008;148(6):409–418.
Gordon JR, Lowy FD. Pathogenesis of MRSA infection. Clin Infect Dis. 2008;46(5):S350–S359.
Jarvis WR, Schlosser J, Chinn RY, Tweeten S, Jackson M. National prevalence of methicillin resistant Staphylococcus aureus in inpatients at a US healthcare facilities. Am J Infect Control. 2007;35(10):631–637.
Haznedaroglu T, Oncul T, Hosbul S, Cavuslu O, Ozyurt M et al. Methicillin resistance in Staphylococcus aureus strains isolated from hospitalized patients: three year trend. TAF Prevent Med Bull. 2010;9(6):585–590.
Ramirez-Castillo, Flor Y, Adriana C, Moreno-Flores, Francisco J, Avelar-Gonzalez, Francisco–Marquez-Diaz, Josee H, Alma L, Guerrero-Barrera. An evaluation of multidrug resistant Escherichia coli isolates in urinary tract infections from Aguascalientes, Mexico: Cross section study. Ann CLin Microbiol Antimicrob. 2018;17:34.
Bubonja-Sonje M, Matovina M, Skrobonja J, Bedemic B, Abram M. Mechanism of Carbanepem resistance in multidrug resistant clinical isolates of Pseudomonas aeruginosa from a Croatian hospital. Microbiol Drug Resist. 2015;21(3):261–269.
Labarca JR, Salles MJ, Seas C, Guzman-Blanco M. Carbanepem resistance in Pseudomonas aeruginosa and Acinebacter baumanii in the nosocomial setting in Latin America. Critical Rev Microbiol. 2016;42(2):276–292.
Nsofor CA, Anyanwu NC, Ogbulie TE. High antibiotic resistance pattern observed in bacterial isolates from a tertiary hospital in South east Nigeria. Int J Res Pharm Biosciences. 2016;3(1):1–6.
Jombo GT, Emanghe UE, Amefule EN, Damen JG. Urinary tract infections at a Nigerian University hospital, causes and antimicrobial susceptibility profile. J Microbiol Antimicrob. 2011;3:53–59.
Muluye D, Wondimeneh Y, Ferede G, et al. Bacterial isolates and their antibiotic susceptibility pattern among patients with pus and /or wound discharge at Gondar University hospital. BMC Res Notes. 2014;7(1):619.
Ruiz J, Villareal E, Gordon M, Frasquet J, Castellanos A, Ramirez P, et al. From MIC creep to MIC decline: Staphylococcus aureus antibiotic susceptibility evolution over the last 4 years. Clin Microbiol Infect. 2016;22(8):741–742.
Trojan R, Razdan L, Singh N. Antibiotic susceptibility pattern of bacterial isolates from pus samples in a tertiary care hospital of Punjab, India. Int J Microbiol; 2016.
[Article ID 9302692]
Kariuki S, Gordon MA, Feasey N, Parry CM. Antimicrobial resistance and management of invasive Salmonella disease. Vaccine. 2015;33(Suppl 3):C21–C29.
Le Doare K, Bielicki J, Heath PT, Sharland M. Systematic review of antibiotic resistance rates among gram negative bacteria in children with sepsis in resource limited countries. J Pediatr Infect Dis Soc. 2014;4(1):11–20.
Leopold SJ, van Leth F, Tarekegn H, Schultsz C. Antimicrobial drug resistance among clinically relevant bacterial isolates in sub Saharan Africa: A systematic review. J Antimicrob Chemother. 2014;69(9):2337–2353.
Blomberg B, Jureen R, Manji RP, Tamin BS, Nwakagile DSM, Urassa WK, et al. High rate of fatal causes of pediatric septicemia caused by gram negative bacteria with extended spectrum beta-lactamases in Dar es Salam, Tanzania. J Clin Microbiol. 2005;43:745–749.
Masyeni S, Sukmawati H, Siskayani AS, Dharmayanti S, Sari K. Antimicrobial susceptibility pattern of pathogens isolated from various specimens in Denpasar – Bali: A two years retrospective survey. Biomed Pharmacol J. 2018;11(1):493–502.
Sewunat T, Demissie Y, Mihret A, Abebe T. Bacterial profile and antimicrobial susceptibility pattern of isolates among burn patients at Yekatit 12 hospital burn centre, Adis Ababa, Ethiopia. Ethiopian J Health Sci. 2013;23(3):209–216.
Dilnessa T, Bitwe A. Prevalence and antimicrobial susceptibility pattern of Methicillin resistance Staphylococcus aureus isolated from clinical samples at Yekatit 12 hospital medical college, Adis Ababa, Ethiopia. BMC Infect Dis. 2016;398.
Ragbetli C, Parlak M, Bayram M, Guducuoglu H, Ceylan N. Evaluation of antimicrobial resistance in Staphylococcus aureus isolates by years. Interdisciplinary Perspect Infect Dis. 2016;ID9171395.
Ramirez–Castillo FY, Moreno–Flores A, Avelar–Gonzalez FF, Marquez–Diaz F, Harel J, Guerrero–Barrera AL. An evaluation of multidrug resistant Escherichia coli isolates in urinary tract infections from Aquascalientes. Mexico: Cross sectional study. Ann Clin Microbiol. 2018;17:34.
Acquah SE, Quaye L, Sagbe K, Ziem JB, Bromberger P, Amponsem AA. Susceptibility of bacterial etiological agents to community used antimicrobial agents in Children with sepsis at the Tamale teaching hospital. BMC Infect Dis. 2013;18(13):89.
Mordi RM, Momoh MI. Incidence of Proteus species in wound infection and their sensitivity pattern in University of Benin teaching hospital. Afr J Biotech. 2009;8(5):725–730.
Kehinde AO, Ademola SA, Okesola AO, Oluwatosin OM, Bakare RA. Pattern of bacterial pathogens in burn wound infection in Ibadan, Nigeria. Ann Burns Fire Disasters. 2004;17(1):12– 15.
Hansen DS, Auken HM, Abiola T, Podschun R. Recommended test panel for differentiation of Klebsiella species on the basis of trilateral inter-laboratory evaluation of 18 biochemical tests. J Clin Microbiol. 2004;42:3665–3669.
Chakraborty S, Moshina K, Sarker PK, Alam MDZ, Sayem SMA. Prevalence, antibiotics susceptibility profiles and ESBL production in Klebsiella pneumoniae and Klebsiella oxytoca among hospitalized patients. Periodicum Biologocum. 2016;118(1):53–58.
Olowe OS, Oladapo GO, Makajuola OA, Olaitan JO. Prevalence of extended spectrum beta – lactamases [ESBLs] carrying genes in Klebsiella species from clinical samples at Ile – Ife, South west Nigeria. Int J Pharm Med Biosci. 2012;1(2):129–138.
Mahmoud AM, Tarig MSA, Osama MS, Mariam MA. Prevalence and antimicrobial resistance pattern of bacterial strains isolated from patients with urinary tract infections in Messalata central hospital, Libya. Asian Pacific J Trop Med. 2016;9(8):771–778.
Putil HV, Patil VC. Incidence, bacteriology and clinical outcome of ventilator associated pneumonia at tertiary care hospital. J Natr Sci Biol Med. 2017;8(1):46–55.
Akter J, Masadil Azad Chowdhury AM, Forkan M. Study on prevalence and antibiotic resistance pattern of Klebsiella isolated from clinical samples in South east region of Bangladesh. Am J Drug Delivery Dev. 2014;4(1):73–79.
Riaz S, Faisal M, Hasnain S. Prevalence and comparism of beta-lactamase producing Escherichia coli and Klebsiella species from clinical and environmental sources in Lahore, Pakistan. Afr J Microbiol Res. 2012;6:465–470.
Sarathbau R, Ramani TV, Bhaskara K, Panda S. Antibiotic susceptibility pattern of Klebsiella pneumoniae isolated from sputum, urine and pus samples. J Pharm Biol Sci. 2012;1:4–9.
Prasad RR, Shree V, Sagar S, Kumar S, Kumar P. Prevalence and antimicrobial susceptibility pattern of Proteus species in clinical samples. Int J Curr Microbiol App Sci. 2016;5(4):962–968.
Bahashwan SA, El Shafey HM. Antimicrobial resistance pattern of Proteus isolates from clinical isolates from clinical specimens. Europ Sci J. 2013;9(27):1857–1881.
Bernabe KJ, Langendorf C, Ford N, Baptiste Ronat J, Murphy R. Antimicrobial resistance in West Africa: A systematic review and meta – analysis. Int J Antimicrob Agents. 2017;50:629–639.
Aydin N, Gultekin B, Eyigor M, Gurel M. The antibiotic resistance of Staphylococuss aureus isolated of clinical specimens. Adan Menderes Universitesi Tip Fakultesi Dergisi. 2001;2(3):21–26.
Ozkalp B, Baybek H. In vitro susceptibility to various antibiotics of Staphylococcus aureus isolated from clinical specimens. Genel Tip Derg. 2003;13(2):65–68.
Ali Abdel Rahim KA, Ali Mohamed AH. Prevalence of extended spectrum beta – lactamase producing Klebsiella pneumoniae in clinical isolates. Jundishapur J Microbiol. 2014;7(11): e17114.
Dash M, Padhi S, Mohanty I, Panda P, Parida B. Antimicrobial resistance in pathogens causing urinary tract infections in a rural community of Odisha, India. Indian J Family Community Med. 2013;20:20–26.
Niranjan V, Malini A. Antimicrobial resistance pattern in a Escherichia coli causing urinary tract infections among inpatients. Indian J Med Res. 2014;139:945–948.
Dugal S, Purohit H. Antimicrobial susceptibility profile and detection of extended spectrum beta-lactamases production by gram negative uropathogens. Int J Pharm Pharm Sci. 2013;5:434– 438.
Olorunmola FO, Kolawole DO, Lamikanra A. Antibiotics resistance and virulence properties in Escherichia coli strains from cases of urinary tract infections. Afr J Infect Dis. 2013;7(1):1–7.
Sharma J, Singh S, Kaur Gill A, Kaur A. Prevalence and antimicrobial susceptibility pattern of Pseudomonas aeruginosa isolated from pus samples in a tertiary care hospital. Bathinda. Int J Contemporary Med Res. 2016;3(12):3481–3483.
Khan F, Khan A, Kazmi SU. Prevalence and susceptibility pattern of multidrug resistant clinical isolates of Pseudomonas aeruginosa in Karachi. Pak J Med Sci. 2014;30(5):951–954.
Naik TB, Nadagir SD, Biradar A. Prevalence of Beta – Hemolytic Streptococci groups A, C and G in patients with acute pharyngitis. J Lab Physician. 2016;8(1):45–49.
Rossolini GM, Arena F, Pecile P, Pollini S. Update on the antibiotic crisis/ Clin Opin Pharmacol. 2014;18:56–60.
Golkar Z, Bagazra O, Pace DG. Bacteriophage: A potential solution for the antibiotic resistance crisis. J Infect Dev Ctries. 2014;8(2):129–136.
Bartlett JG, Gilbert DN, Spellberg B. Seven ways to preserve the miracle of antibiotics. Clin Infect Dis. 2013;56(10): 1445–1450.
Luyt CE, Brechot N, Trouillet JL, Chastre J. Antibiotic stewardship in the intensive care unit. Crit Care. 2014;18(5):480.