Co-Prevalence of Quinolone Resistance and Extended-Spectrum Beta-Lactamases among Clinical Enterobacteriaceae Isolates from a Tertiary Hospital in Katsina, Nigeria

Abstract

Study’s Novelty/Excerpt This study investigates the co-existence of Extended-Spectrum Beta-Lactamases (ESBLs) and quinolone resistance among clinical Enterobacteriaceae isolates, highlighting the high prevalence of multidrug resistance (MDR) and extensive drug resistance (XDR). By employing the VITEK-2 Compact automated identification system, the research demonstrates that a significant proportion of quinolone-resistant Enterobacteriaceae are also ESBL-positive, with co-resistance observed primarily in Escherichia coli and Klebsiella pneumoniae. These findings emphasize the critical need for continuous surveillance and antibiotic stewardship to mitigate the growing threat of antimicrobial resistance and align with Sustainable Development Goals (SDG) 3 for good health and well-being. Full Abstract Antimicrobial resistance (AMR) poses a major hazard to global public health. It reduces the effectiveness of many antibiotics, making infections harder to cure and raising the likelihood of disease transmission and death. Globally, beta-lactam and quinolone antibiotics are among the commonly prescribed medications. Yet, a multitude of bacteria have evolved distinct multidrug resistance (MDR) characteristics, rendering many of these important drugs worthless. This study aimed to investigate the magnitude of the simultaneous occurrence of Extended-Spectrum Beta-Lactamases (ESBLs) and Quinolone-resistance (co-existence) among clinical Enterobacteriaceae isolates. A total of 95 Enterobacteriaceae pathogens isolated from different human samples were obtained from a Tertiary Hospital in Katsina. Then, the VITEK-2 Compact automated identification system was employed for the identification and antimicrobial susceptibility testing (AST) and the ESBL screening of isolates. This study showed that out of the total 95 isolates, 67 (70.5%) were quinolone-resistant, while 53 (55.8%) were ESBL-positive. Most of the quinolone-resistant (QRE) Enterobacteriaceae were ESBL-positive, 50 (74.6%), and conversely, most of the ESBL-positive Enterobacteriaceae were quinolone-resistant (50, 94.3%). Co-resistance (quinolone-resistance and ESBL-positive) was recorded in 50 (52.63%) of the isolates, all belonging to the Escherichia coli (42, 84.0%) and Klebsiella pneumoniae (8, 16.0%). Almost all the co-resistant isolates were resistant to the tested quinolones [Ciprofloxacin (49, 98.0%) and Levofloxacin (50, 100.0%). The lowest resistance was recorded to Ertapenem(6.0%), Meropenem (6.0%), and Amikacin (2.0%), and the highest to Ampicillin, Piperacillin and Levofloxacin (100.0% each). Almost all the co-resistant isolates were multidrug-resistant (MDR), 49 (98.0%), while 33 (66.0%) were extensively drug-resistant (XDR). According to the collected samples’ demographic data, the highest prevalences were recorded among males (60.0%, based on gender), adults (50.0%, based on age), and urine (48.0%, based on sample). Continuous surveillance and stewardship are essential to achieve good health and well-being (Sustainable Development Goal 3).