Phenotypic Characterization of Carbapenem-Resistant Enterobacteriaceae in Presumptive Tuberculosis Patient across One Health Interface

Abstract

Introduction Globally, Nigeria remains one of the 30 countries highly burdened with tuberculosis (TB), TB/Human immunodeficiency virus and multidrug-resistant TB (MDR-TB). Objective This study aimed to characterize carbapenem-resistant Enterobacteriaceae (CRE) in presumptive tuberculosis patients across one health interface. Methods Sixty-six sputum samples from presumptive tuberculosis patients, fecal samples of animals loitering the hospital and environmental soil samples were collected and characterized. Isolated Enterobacteriaceae were screened for multidrug resistance and characterized for carbapenemase production. Result Fifty-seven enterobacteriaceae were isolated from 66 samples of sputum, fecal and soil samples. The frequency of occurrence of Klebsiella pneumoniae was 66.7% and 100% in sputum and fecal samples, respectively, while 60% of the soil sample was Proteus mirabilis. Multidrug resistance was exhibited, with ceftizidime showing the highest resistance of 100%, augumentin (95.7%), and nitrofurantoin (59.6%) in sputum samples. Animal and fecal samples showed similar resistance patterns to antibiotics with gentamicin, cefixime augementin and nitrofurantin. Majority (70.2%) were carbapenemase-producing Enterobacteriaceae, while only 34% were producing metallo-beta lactamase from sputum samples. Conclusions: The interconnectivity and frequency of CRE occurrence was found to be high in this study across the three pillars of One Health.