Prevalence of extended spectrum β-Lactamase producing Escherichia coli and it’s antimicrobial susceptibility patterns in effluents from Mulago National Referral Hospital

Abstract

This was a cross sectional study carried out from March to April 2019 at Mulago National Referral Hospital in Kampala district. Samples of effluents from accessible channels of Mulago National Referral Hospital wards were collected in the morning and evening Background Extended Spectrum Beta-lactamase (ESBL)-producing Escherichia coli have become an emerging global health threat and are associated with high mortality (WHO, 2014). Production of Beta-lactamase enzymes that hydrolyze the β-lactam ring is a major resistance mechanism for several Gram-negative bacteria including Enterobacteriaceae such as E. coli, Klebsiella pneumoniae, Klebsiella oxytoca, Pseudomonas aeruginosa among others Materials and methods This cross sectional study was conducted between March – May, 2019. Sampling was consecutive from the different ward sewage channels, a total of 100 samples were collected and tested for phenotypic ESBL production using synergy test using Ceftazidime-clavulanic acid and Cefotaxime-clavulanic acid. Results Results showed 100% resistance and 0% susceptibility to both Tetracycline and Ampicillin whereas Ciprofloxacin had 66% susceptibility and 34% resistance, Nalidixic acid had 59% susceptibility and 41% resistance, and Gentamycin had 60% susceptibility and 40% resistance. The results also showed that the prevalence of extended spectrum beta lactamase producing E. coli was 50% (n=100) when using Cefotaxime-Clavulanic acid combination while the prevalence of extended spectrum beta lactamase producing E. coli was 49% (n=100) when using Ceftazidime-Clavulanic acid combination. Conclusion This study revealed a high prevalence of ESBL producing E. coli from Mulago National Referral Hospital and high levels of resistance to third generation cephalosporins specifically Ceftazidime and Cefotaxime. In addition to undertaking appropriate infection control measures, there is urgent need for formulation of an antibiotic policy in Uganda to prevent spread of these organisms. This also calls for continuous monitoring and reporting of the presence of such organisms in order to ensure rational and judicious use of antibiotics by clinicians.