Biofilm Formation and Antibiotic Resistance of Uropathogens Isolated from Patients attending a Teaching Hospital in Anambra State Nigeria

The main aim of this research was to characterize the enterobacterial uropathogens with respect to drug resistance in Awka, south-eastern Nigeria. The following enterobacterial uropathogens isolated from patients attending Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka were studied: E.coli (58), Salmonella spp. (15), K. pneumoniae (14), Citrobacter freundii (10) and Enterobacter aerogenes(3). Their antibiotic susceptibility patterns against major classes of antibiotics were evaluated using agar disk diffusion assay. The resistant uropathogens were analyzed for the presence of biofilm using modified Christensen method and the presences of beta-lactamases among the isolates were checked using multiplex PCR. The antibiotic susceptibility of the isolates showed that 60% of the E.coli isolates were resistant to cefpodoxime but were highly susceptible to the fluoroquinolones with the exception of ciprofloxacin. Salmonella isolates on the other hand, had a very good susceptibility profile to the 3rd generation cephalosporins but were resistant to ofloxacin and cotrimoxazole. Klebsiella pneumoniae isolates were resistant to cefpodoxime, cefotaxime and cotrimoxazole but sensitive to the fluoroquinolones. Biofilm producing isolates were 74% while the non biofilm formers were 26%. Out of the 54 E. coli that were screened for ESBL production, 35 were confirmed positive for ESBL production with PCR. The predominant ESBL gene was blaTEM with blaSPM being the most predominant MBL gene. Out of the 21 isolates that were screened positive for AmpC production, only one was confirmed positive using PCR. Nine out of 10 K.pneumoniae that was screened to be positive for ESBL production were confirmed positive by PCR. All the 10 C. freundii were positive for ESBL genes and some organisms had co-expression of genes. This study showed high prevalence of drug resistant genes among the enterobacterial uropathogens.