Genotypic characterization of extended-spectrum β-lactamase producing urinary isolates among pregnant women in Ho municipality, Ghana
Date
2022
Journal Title
Journal ISSN
Volume Title
Publisher
Heliyon
Abstract
Objective: The case of antibiotic resistance has become a major global concern and Extended Spectrum β-lactamase
(ESBL) producing organisms have so far remained the biggest culprit. The consequences of urinary tract infection
(UTI) and antibiotic resistance among pregnant women cannot be underestimated. We investigated UTI and ESBL
production among urinary pathogens isolated from pregnant women.
Method: We obtained non-repeat, clean catch midstream urine samples from 1345 pregnant women suspected of
having UTI for bacterial identification at the Ho Teaching Hospital Laboratory between June 2013 and March
2015. The isolates were taken through relevant biochemical testing for identification and then subjected to
antimicrobial agents for susceptibility testing using the disc diffusion method. We tested for ESBL production by
the combined disc method and ESBL positive (þESBL) phenotype isolates were genotyped for BlaTEM, BlaSHV, and
BlaCTX-M using polymerase chain reaction (PCR). Data were analyzed using SPSS v24 and p-values < 0.05 were
considered statistically significant.
Results: Of the 1345 urine samples tested, 230 (17.1%, 95% CI: 15.1%–19.1%) yielded significant bacteriuria. The
most common bacterium isolated was Staphylococcus aureus (29.6%) followed closely by Escherichia coli (28.7%)
both of which were highest during the second trimester of gestation. We isolated 152 gram-negative isolates with
41.4% (63/230) being þ ESBL. Of the 63 þ ESBL, 45 (71.4%) possessed blaTEM, 42 (66.7%) had blaCTX-M and 2
(3.2%) possessed blaSHV genes; 38 possessed multiple ESBL genes comprising 2 with both SHV and TEM genes and
36 with both CTX-M and TEM genes.
Conclusion: High prevalence of UTI and persistent transmission of ESBLs among pregnant women in the Ho
Municipality is worrying and a course for public health concern. We recommend urine culture during pregnancy
as a routine laboratory investigation to avoid birth-related complications.
Description
Research Article
Keywords
Extended spectrum β-lactamase, Antimicrobial, Urinary bacteria, Antenatal clinini