MOBILE COLISTIN RESISTANCE IN ENTEROBACTERALES FROM CLINICAL ISOLATES AT A TERTIARY HOSPITAL IN NORTHWEST, NIGERIA: A CROSS-SECTIONAL STUDY

Abstract

Antimicrobial resistance (AMR) is an established global problem warranting reliance on antibiotics of last resort. Plasmid-mediated resistance to colistin has emerged and is spreading across the globe, especially among Enterobacterales. This study set out to detect colistin-resistance and other AMR in Enterobacterales from clinical isolates at a tertiary hospital in Nigeria. This was a hospital-based cross-sectional study at Usmanu Danfodiyo University Teaching Hospital Sokoto, Nigeria. Enterobacterales were isolated from different clinical samples, identified using the Analytical Profile Index 20E system, and subjected to antibiotic susceptibility testing. Colistin resistance was detected phenotypically using the Colistin Broth Dilution and Elution Method. Polymerase chain reaction was performed to detect mcr genes. A 12.5% (N=320) overall prevalence of colistin resistance was found and only mcr-2 was detected, which was found in an isolate of Escherichia coli. Escherichia coli (51.6%) and Klebsiella pneumoniae (29.1%) were the most common Enterobacterales implicated in all infections. More the 60% of the isolates were multidrug-resistant to co-trimoxazole, gentamicin, ceftazidine, and ceftriaxone. This study reports the first mcr gene from a clinical sample and a high prevalence of multidrug-resistant Enterobacterales infections in northwest Nigeria. This study call for urgent implementation antibiotic stewardship in our hospitals so as to limit the spread of antibiotic-resistant bacteria in our healthcare facilities.