PREVALENCE OF EXTENDED SPECTRUM BETA – LACTAMASE PRODUCING BACTERIA AMONG URINARY TRACT INFECTED PATIENT ATTENDING TWO SELECTED HOSPITALS IN KANO

Background: Urinary tract infection is caused mostly by different bacteria of family Enterobacteriaceae in the hospital and community acquired infection. Emerging increasing resistance has been observed among uropathogens of the family Enterobacteriaceae. Extended spectrum beta lactamase genes encode for multidrug resistance and unrestricted use of antibiotics in hospitals and pharmacy counter provides an environment for development of more resistant strain with limited treatment options. This necessitates therapies based on culture and antimicrobial sensitivity to improve patients’ outcomes. Objective: The purpose of the present study was to find out the bacteria causing urinary tract infection, their antibiotic resistance pattern and the prevalence of ESBL among Enterobacteriaceae isolated. Methodology: This cross-sectional descriptive study was conducted at Murtala Muhammad Specialist Hospital and Infectious Disease Hospital Kano, Nigeria, from December 2023 to February, 2024 for a period of 2 month. Demographic data were obtained by use of questionnaires. 204 urine samples of patient who were presented with infection in the urinary tract in the two hospitals were included as study population. The urine specimen was inoculated on cysteine lactose electrolyte deficient (CLED) agar plates and incubated at 37°C for 24 hours. Identification was based on standard microbiological methods. The Susceptibility testing was done by modified Kirby Bauer technique. Clinical Laboratory Standards Institute guidelines 2023 (CLSI 2023) were used for screening and confirmation of ESBL production respectively. Double Disk Synergy Test method was used for confirmation of ESBL. The result was analysed using Descriptive Statistic in SPSS version 16. Results: Of the 204-urine processed, 43 (65.2%) were gram negatives and 41 were Enterobacteriaceae, Isolation rates were Escherichia coli‑39.5%, Klebsiella spp. ‑25.6%, Citrobacter spp.‑18.6%, Enterobacter‑7.0%, Pseudomonas aeruginosa‑1.2%, Acinetobacter baumanni‑1.2%, Proteus vulgaris‑1.2% and Yersinia‑1.2%. Among Enterobacteriaceae, 9 (21.95%) were ESBL producers. Prevalence of ESBL were 35.3% for Escherichia coli, 28.6% for Klebsiella pneumoniae and 12.5% for Citrobacter species. Susceptibility showed that gram negative Isolates were highly susceptible to Gentamycin (86.04%) and Nitrofurantoin (67.5%). Resistance to third generation of cephalosporins varies from 48.84% - 75.2%, while Amoxicillin has 72.1% resistance. Conclusion: We recommend Gentamycin and Nitrofurantoin for empirical treatment; Individual should practice personal hygiene to avoid spread of this bacteria in the community.