Carbapenem resistance among order enterobacterales from tertiary hospital in Bauchi State Nigeria

Abstract

The burden of antimicrobial resistance (AMR) is rapidly growing across antibiotic classes, with increased detection of isolates resistant to carbapenems. Data on the prevalence of carbapenem resistance in developing countries is limited; therefore, in this study, the study determined the prevalence of carbapenem resistance genes among order Enterobacterales isolated from clinical specimens in Bauchi State. A total of 315 isolates were analyzed for carbapenem resistance genes. For each isolate, two different PCR assays were performed, allowing for the detection of the major carbapenem resistance genes, using the primers blaCTX, blaCMY, blaTEM and blaNDM. CTX-types 19(22.3%) were the most predominant gene followed by TEM-typeswith 9(10.5%) incident. The genes were predominantly detected in E. coli 22 (25.8%), followed by K. pneumonia 10(11.7%). The report of this study  have demonstrated for the first time the prevalence and co-existence of Carbapenamase producing carbapenem resistance (NDM) and non carbapenamase producing carbapenem resistance (CTX,TEM and CM-Y) from K. pneumonia in Bauchi State. This finding revealed the resistance rate of ampicillin, Amoxiclav, ceftazidime as 79.4%, 46.9% and 32.0% respectively. Imipenem and Meropenem were found to be considerably active to most of the isolates but not to CRE. The highest CRE was observed from CP-CRE 28.2% followed by ESBL producing CRE 16.5% and AmpC producing CRE 22.3%. Coexistence of betalactamases occurs from 32.9 % isolates from which 24.7% were ESBL, Ampicillin and Carbenicillin (AmpC) betalactamases producers while 8.2% isolates were ESBL and carbapenamases producers with K. pneumoniae carbapenemase producing species.