Antibiotic susceptibility profile of uropathogens isolated from pregnant women in selected hospitals in Ilorin

Background: Urinary tract infection (UTI) is one of the most common infections among pregnant women and if untreated could lead to serious complications.Objective: This work was carried out to determine the prevalence rate of Enterobacteriaceae uropathogens and their antibiotics susceptibility profile among pregnant women attending two ante-natal clinics in Ilorin, Nigeria.Materials and Methods: A total of 111 pregnant women between the ages of 18-50 attending ante-natal clinic at University of Ilorin Teaching Hospital and Civil Service Hospital, Ilorin participated in the study. Mid-stream urine samples were collected and cultured on Cysteine-Lactose-Electrolyte Deficient agar. Presence of significant bacteriuria (> 105 cfu/mL) was determined using the plate count method. Antibiotic susceptibility testing was done using Kirby-Bauer disk diffusion technique.Results: Of the 111 urine samples collected, 27.9% of them were found positive on culture. Among the isolated organisms, Klebsiella oxytoca (25.7%) followed by Klebsiella pneumonia (22.9%), were the most prevalent. Isolated bacteria were resistant to at least one antibiotic with the highest resistance seen with amoxicillin (94.3%), streptomycin (77.1%) and nitrofurantoin (54. 3%). Amoxicillin-clavulanic acid (51.4%), ceftriaxone (51.4%), ceftazidime (34.3%), cotrimoxazole (51.4%), imipenem (2.9%), ciprofloxacin (14.3%) and gentamicin (25.7%) have the lowest rate of bacteria resistance. Of the isolates, 82.9% showed Multi-Antibiotic Resistance Index (MARI) ≥ 0.3.Conclusion: High prevalence of bacteriuria in both symptomatic and asymptomatic pregnant women was observed in the study areas. The alarming rate of multi-antibiotic resistance strain is therefore an indicator of a serious clinical problem in the community.Keywords: Bacteriuria, pregnancy, urine culture, antibiotic susceptibilit

Molecular Characterization of Extended Spectrum Beta – Lactamase Producing Escherichia Coli Isolated from Pregnant Women with Urinary Tract Infections Attending Ante–Natal Clinics in Ilorin Metropolis

Background: The emergence of multidrug- resistance Enterobacteriaceae especially in E. coli bacteria  associated with Urinary Tract Infections (UTIs) in pregnancy is a serious menace globally posing health challenges and confounding successful empirical treatment as well as increasing pregnancy – related  complications.Objectives: The aim of this study is to determine the phenotypic and genotypic characteristics of Extended Spectrum Beta – Lactamases (ESBLs) producing E. coli (ESBLs – EC) isolates in pregnant women attending ante – natal clinics within Ilorin - Kwara State, Nigeria.Materials and methods: A total of 53 non - repeated E. coli isolates from urine samples of pregnant women were presumptively identified using standard bacteriological method and confirmed by commercially available Microgen® Identification Kits. Phenotypic detection of ESBLs was determined using antibiotics susceptibility test and double disc synergy Method for screening and confirmation respectively. Polymerase Chain Reaction (PCR) was further used for the genotypic detection of ESBLs genes.Results: A total 88.67% (47/53) of E. coli exhibited resistance to the cephalosporins of which aztreonam was the highest (75.47%) and the least was cefpodoxime (35.84%) while 85.10% were confirmed positive for ESBL production. The genotypic detection showed the most occurring genotype was blaTEM (50%) blaOXA (27.7%), blaGES (22.5%), blaSHV (15%), blaCTXM and blaVEB (7.5%) while sixty – four (64%) of isolates co – harbored two or more gene. BlaTEM and blaOXA were dominant.Conclusion: This study showed high resistance of E. coli to the third generation cephalosporins harboring different ESBL genes which increases UTIs complexity and limit therapeutic options in pregnancy. Therefore, continuous monitoring of resistance in E. coli, effective appraisal of antibiotic control policies and rational use of antibiotics is therefore encouraged