High level detection of extended spectrum beta-lactamase gene encoding Enterobacteriaceae in public toilets in Abeokuta, Nigeria

Abstract

Increasing reports of the pandemic nature of extended spectrum β-lactamase (ESBL) producing bacteria in clinical infections called for more surveillance to identify possible sources of infection. This study examined the dissemination of ESBL producing Enterobacteriaceae in hospital and public toilet facilities in Abeokuta. Swab samples were collected from toilet seats, door handles, toilet bowls and flush handles. Detection of ESBL producing isolates was done using double disc test. Presence of ESBL gene was done using multiplex PCR. Overall, ESBL-producing bacteria was detected in 44 (27.5%) out of 160 samples. ESBL-producing bacteria were detected at significantly higher rate )p<0.001) in hospital toilets than in community toilets. Isolates were identified as Klebsiella pneumoniae (n=25), Klebsiella oxytoca (n=2), Citrobacter freundii (n=6), Citrobacter youngae (n=3), Escherichia coli (n=5), Enterobacter cloacae (n=2) and Enterobacter kobei (n=1). . Analysis for the presence of ESBL gene showed that all the isolates harboured the blaCTX-M- gene while blaTEM and blaSHV were detected in six and two isolates respectively. All the ESBL-producing isolates demonstrated resistance to at least three different classes of antimicrobials. The study showed that public toilets could serve as sources for nosocomial and community transmission of ESBL-producing bacteria in the environment.

Keywords

• esbls
• enterobacteriaceae
• bla ctx-m-15
• public toilets
• nosocomial transmission
• multidrug resistance