Characterization of selected multidrug-resistant bacteria from clinical and hospital environmental sources using Vitek 2 compact system

Abstract

Abstract Background: Antibiotics resistant bacteria (ARB) are a global problem. Patients and hospital environments can be sources for dissemination of ARB that are Multi-drug Resistant (MDR). Methods: We characterized MDR bacteria from clinical and hospital environments from selected hospitals within Katsina State, Nigeria. A total of 203 bacteria were isolated from 420 samples (clinical= 220 and hospital environment=200). Bacteria preliminary identification and antibiogram were determined by biochemical characterization and Kirby Bauer disk diffusion method, respectively. MDR bacteria were selected based on resistance to 3 classes of antibiotics. MDR bacteria were further identified and characterized with vitek-2- compact system. The micro-dilution automated system further identified Proteus mirabilis, Enterobacter cloacea spp dissolvens, Enterobacter cloacea and Pseudomonas aeruginosa as MDR isolates with the highest resistance phenotypes. Results: Staphylococcus aureus was the most frequently isolated bacteria from clinical samples; i.e. infected surgical incisions (23.58%) and infected trauma wounds (20.75%) and hospital environmental samples; i.e. door handles (32.98%) and desks (14.43%). Highest resistance (92.79%) each to ampicillin and gentamycin was observed among hospital environmental isolates. Clinical isolates showed highest (80.19%) resistance to cefoxitin. MDR bacteria showed 12 antibiotics resistance patterns and most common (20/50) resistance phenotypes among MDR clinical isolates was to amoxiclav, cefoxitin and ciprofloxacin while resistance to ampicillin, chloramphenicol, colistin sulphate, kanamycin and nalidixic acid was commonly (10/50) observed among hospital environmental isolates. Conclusions: High occurrence of MDR bacteria in the studied locations may be disseminated among patients, healthcare workers and the environment, and portend a great public health consequence. Hence, there is need for concerted AMR surveillance in these locations.