Molecular Characterization of Multidrug-resistant Enterobacteriaceae-associated Urinary Tract Infections in a Geriatric Population in Port Harcourt Metropolis, Rivers State, Nigeria

Background: Bacteria belonging to the Enterobacteriaceae family are responsible for most of the urinary tract infection globally with disproportionate levels of burden among vulnerable populations.

Aim: This study evaluated the burden and also characterized the species of bacteria associated with a disadvantaged population, the geriatric group, in the Port Harcourt metropolis of Rivers State in Nigeria.

Study Design: This study was a cross-sectional study which employed a simple random sampling method.

Methods: Conventional techniques were used to isolate the pathogen. Molecular methods were used to confirm the 16S rRNA, NDM-1, KPC and QnrA genes. Gene sequencing was performed on the 16S rRNA gene and an evolutionary relationship tree was plotted.

Results: The prevalence of urinary tract infection (UTI) among the elderly was 33.3% with the females having (32.6%) a higher prevalence than the males (31.3%). Escherichia coli had the highest prevalence (38%) while Proteus mirabilis showed the lowest level of prevalence. The cephalosporin class of antibiotics demonstrated the highest resistance profile (100%). NDM-1 targeted gene (550 bp) was detected in one of the Klebsiella pneumoniae while the KPC targeted gene (600 bp) was detected in another Klebsiella pneumoniae and Escherichia coli isolates. The 16S rRNA of the isolates confirmed the isolates to be closely related to Klebsiella pneumoniae, Escherichia coli and Proteus mirabilis.

Conclusion: This study demonstrated the presence of a recently discovered resistance gene (NDM-1) among the geriatric populations.