Phenotypic Screening of Beta Lactamase Klebs­iella Species from Isolated Urine Sample

Phenotypic Screening of Beta Lactamase Klebs­iella Species Isolated from EBSU Non-Medical Student Urine Sample

ABSTRACT

The antimicrobial susceptibility pattern was done using disc diffusion method. The isolates were screened for β-lactamase using nitrocefin sticks. The result obtained from this study showed that out of the 50 samples analysed, 15 isolates of Klebsiella species were obtained. Of the 15 isolates, 3.(18.75%) were from males while 13(81.25%) were from females. Antibiotics susceptibility test result showed that Klebsiella species isolated were highly susceptible to Imipenem (100%),. Followed by Gemtamicin and Meropenem (93.75%), each and Ciprofloxin (81.25%). They were highly resistant to Aztreonam and Ampicillin, 100% each. The result of the Beta-lactamase production showed that a total number of 15 isolates were tested and 10(66.7) were beta lactamase positive while 5(33.3) were beta-lactamase negative. This study has revealed that healthy individuals are also carriers of organisms that produce β-lactamase; and therefore, there is an urgent need to control and prevent the spread of these life threatening organisms.

CHAPTER ONE

      INTRODUCTION

1.1 Background of the Study

Escherichia coli cause about 80 percent of urinary tract infections in adults. These bacteria are normally present in the colon and Antibiotic resistance among bacterial species have become a global issue and the resistance is as a result of some factors which β-lactamase production is one. Beta-lactamases are therefore enzymes produced by bacteria that provide antibiotic resistance to beta lactam antibiotics such as penicillin and carbapenem, although carbapenem are relatively resistant to beta-lactamase. Beta-lactamase provides antibiotic resistance by breaking the antibiotic structure. These antibiotics all have a common element in their molecular structures: a four atom ring known as a Beta lactam. Through hydrolysis, the lactamase enzyme breaks the beta lactamase ring open, deactivation the molecule’s antibacterial properties (Jacoby et al., 2010).

Urinary tract infection is an infection that affects part of the urinary tract. They are one of the most common bacteria infections in humans both in community and the hospital settings (Todar, 2007). Escherichia coli and Klebsiella pneumoniae are the two pre-dominant pathogens commonly isolated in urine. Urinary tract infections (UTI) are caused by infection pathogenic invasion of the urinary tract which leads to an inflammatory response of the urothelium (Woodford and George, 2011). Proliferation of bacteria in the urinary tract is the cause of urinary tract infection. Signs and symptoms may include chills, fever, urge to urinate,cloudy urine,painful urination. Infections are almost always ascending in origin and caused by bacteria in the periurethral flora and the distal urethra. These bacteria inhabit the distal gastrointestinal tract and colonize the perineal area (Perrotta et al., 2009).

Escherichia coli causes about 80 percentage of urinary tract infections in adults. These bacteria are normally present in the colon and May enter the urethral opening from the skin around the anus and genitals. Other bacteria that cause urinary tract infection include Klebsiella, Staphylococcus saprophyticus, Chlamydia  trachomatis, and  Mycoplasma  hominis. Men and women infected with Chlamydia trachomatis or mycoplasma hominiscan transmit the bacteria to their partner during sexual intercourse, causing UTIs. Klebsiella species are one of the commonly encountered Gram- negative pathogens in hospital acquired infections. It is well known cause of community acquired bacterial pneumonia occurring particularly in chronic alcoholics, causing severe pyogenic infections with a high fatality rate if left untreated (Podscum et al., 1998). Klebsiella pneumonia strains are opportunistic pathogen and can cause infections in the urinary tract infection, nosocomial infection, surgical wound sites, diarrhea, and respiratory tract infection (Khadri  et al., 2007). It is resistant to a number of antibiotics mainly extended – spectrum cephalosporin’s and penicillin’s, due to acquisition of plasmid that encode for the production of expended – spectrum β–lactamases (ESBL) especially TEM and SHEV enzymes have been described worldwide (Sahly et al., 2004).Urine tract infection infect both men and Women but women are more prone to urinary tract infection than men because their urethra are closer to the anus, the source of UTIs- causing bacteria. It is common among all ages from infants to elderly persons.

Antibiotic resistance varies according to geographic locations and is directly proportional to the use or misuse of antibiotics. Resistant bacteria can spread to other people once selected in one patient. To prevent such spread basic infection control measures can help but these steps may be undermined in high pressure care setting by rapid bed turnover in hospitals, frequent transfers between care settings, overcrowding of medical and nursing staff (Pitout et al., 2005). Within hospitals, multidrug resistance is most prevalent where antimicrobial use is greatest, notably in intensive care units and other high dependency units and especially in immune – compromised, debilitated or elderly patients, or those with underlying diseases such as cancer, chronic liver disease, diabetes mellitus, chronic renal failure or burns (Paterson, 2007). Also, patients discharged from hospital care can carry resistant organisms into the community, with the result that nursing and residential homes provides large reservoirs for the potential spread of resistanc and its subsequent reintroduction into hospitals (Pitout et al., 2005).

1.2 Aims

This research was aimed at screening the phenotypic production of Beta-lactamase in Klebsiella species isolated from urine samples of EBSU non medical students.

1.3 Specific Objectives

  1. To isolate and characterize Klebsiella species from urine samples collected of EBSU non-medical students.
  2. To investigate their antimicrobial susceptibility patterns to different antibiotics
  3. To Screen for the presence of βeta-lactamases in the Klebsiella species isolated.

 

CHAPTER TWO

2.0                                           LITERATURE REVIEW

2.1    Urinary Tract Infections

A urinary tract infection, or UTI, is an infection of the urinary tract, It is one of the most diagnosed cases, having an estimated figure of 150 million per annum worldwide (Lane and Takhar, 2011). It is the leading cause of Gram- negative bacteremia in patients of all ages and is associated with high risk of morbidity and mortality, especially in the elderly, and account for significant health care costs (Dai et al., 2010). Poor hygiene environment and ignorance have facilitated the socioeconomic devastation of urinary tract infections in developing countries resulting to spending billions to purchase antibiotics for treatment of the infections. Most UTIs are caused by bacteria that enter the urethra and then the bladder. The infection most commonly develops in the bladder, but can spread to the kidneys. Most of the time, the body can get rid of these bacteria. However, certain conditions increase the risk of having UTIs.The risk factors include: female anatomy;A woman has a shorter urethra than a man does, which shortens the distance that bacteria must travel to reach the bladder. Sexual activity: Sexually active woman tend to have more UTIs than women who aren’t sexually active. Having a new sexual partner also increase your risk. Also, Women who use diaphragms for birth control may be at higher risk, as well as women who use spermicidal agents, during Menopause a decine in circulating estrogen causes changes in urinary tract that make you more vulnerable to infection, Urinary tract abnormalities among Babies born with urinary tract abnormalities that don’t allow urine to leave the body normally or cause urine to back up in the urethra have an increased risk of UTIs, Blockages in the urinary tract, Catheter use : People who can’t urinate on their own use a tube to urinate have an increased risk of UTIs. This may include people who are hospitalized, people with neurological problems that make it difficult to control their ability to urinate and people who are paralysed, a recent urinary

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