Screening for Plasmid Mediated Antibiotic Resistance among Multi Drug Resistant Bacteria Isolated from Patients with Lower Respiratory Tract Infections Attending some Hospitals in Kano Metropolis

Abstract

Study’s Novelty/Excerpt This study investigates the prevalence and plasmid-mediated resistance of multidrug-resistant (MDR) bacteria isolated from patients with lower respiratory tract infections (LRTIs), revealing significant findings pertinent to public health. The research demonstrates a high prevalence of MDR isolates (20%) and highlights the substantial role of plasmids, with 67.6% of MDR isolates containing plasmids, and 80% losing drug resistance post-plasmid curing. These results underscore the necessity for treatment options based on antibiotic susceptibility testing and continuous plasmid profiling to combat plasmid-mediated resistance effectively, marking a critical advancement in the management of LRTIs. Full Abstract Lower Respiratory tract infections (LRTIs) are among the serious infections in humans that have been worsening by the emergence of drug resistant bacteria and aggravated by plasmids transfer.  The study aimed to screen Multidrug-resistant (MDR) bacteria isolated from patients with LRTIs for the presence of Plasmid.  Sputum samples (400) were collected from patients with LRTIs and processed using standard microbiological procedures to isolate lower respiratory tract bacteria.  The identified isolates were subjected to antibacterial susceptibility testing using the disc diffusion method.  Multidrug resistant isolates were further subjected to plasmid curing using Acridine orange and the cured isolates were tested for loss of drug resistance.  Among the 400 samples, 185 (46.2 %) harbored significant bacterial growth, with 83 (44.9%) Gram-positive and 102 (55.1%) Gram-negative bacteria.  Bacteria isolated include Escherichia coli (29), Klebsiella pneumonia (46), Moraxella catarrhalis (13), Pseudomonas aerugonosa (14), Staphylococcus aureus(24) and Streptococcus pneumoniae (59).  A higher infection rate was recorded in males (46.99%) and patients aged 41-50 (52.59%).  The highest resistance was exhibited by Klebsiella pneumoniae (93%) against cefuroxime, followed by Streptococcus pneumoniae against oxacillin (75%).  Of the 185 isolates, 37 (20%) were MDR, out of which 25 (67.6%) isolates had Plasmids.  Following curing, 20 (80%) of the isolates were cured, and only 5 (20%) retained their plasmids. Most importantly, Escherichia coli and Klebsiella pneumonia were found to be sensitive to levofloxacin, gentamicin, and imipenem but retained their resistance to Cefuroxime, while Streptococcus pneumoniae was found to be sensitive to levofloxacin only with the highest resistance to oxacillin, doxycycline, and erythromycin. The study establishes a high prevalence of MDR isolates among LRTIs, with some exhibiting plasmid-mediated resistance, and therefore recommends treatment options to be solely based on antibiotic susceptibility testing and continuous plasmid profiling to detect plasmid-mediated resistance to enable appropriate drug administration.