Molecular Detection of Selected Extended-Spectrum Beta-Lactamase Resistant Genes in Escherichia coli Isolated from Cancer Patients with Urinary Tract Infections in Abuja
Main Article Content
Abstract
Urinary tract infections (UTIs) are among the most common infections in cancer patients and are frequently complicated by antimicrobial resistance, particularly due to extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli. This study aimed to determine the prevalence, antimicrobial resistance patterns, and selected molecular characteristics of ESBL-producing E. coli isolated from cancer patients with UTIs at the National Hospital Abuja, Nigeria. A total of 162 urine samples were collected and analyzed using standard microbiological methods. Isolates were identified as E. coli, followed by antibiotic susceptibility testing in accordance with Clinical and Laboratory Standards Institute (CLSI) guidelines. Phenotypic detection of ESBL production was performed using antibiotic susceptibility testing and the VITEK 2 Compact system, while molecular detection of selected ESBL genes was carried out using polymerase chain reaction (PCR). Out of 162 samples, 18 (11.2%) E. coli isolates were recovered. A higher occurrence was observed in males (15.0%) compared to females (9.8%), and among patients aged ≥70 years (21.4%). The isolates exhibited high resistance to ampicillin (100%), cefuroxime (83.3%), trimethoprim-sulfamethoxazole (77.7%), and ceftriaxone (66.6%), while showing complete susceptibility to amikacin and meropenem (100%). Multiple antibiotic resistance (MAR) indices ranged from 0.5 to 0.9, with 0.8 being the most frequent. Of the 18 isolates, 8 (44.4%) were confirmed as ESBL producers. Among these ESBLproducing isolates, blaSHV, blaCTX-M-4, and blaCTX-M genes were detected in 62.5%, 50.0%, and 37.5% of isolates, respectively, while blaTEM was not detected. In conclusion, there is a notable presence of multidrugresistant and ESBL-producing E. coli among cancer patients with UTIs in the study area, posing a significant therapeutic challenge. These findings highlight the need for routine surveillance, antimicrobial stewardship, and the integration of molecular diagnostics in clinical settings, and clinicians are encouraged to adopt evidence-based antibiotic therapy and strengthen infection control practices to limit the spread of resistant strains.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Share – Copy and redistribute the materials in any medium or format.
Adapt – Remix, transform, and build up the materials.
How to Cite
References
Asmare, A., Wubie, M., & Kassa, T. (2024).
Prevalence and antimicrobial resistance patterns
of uropathogenic Escherichia coli: A systematic
review. Pathogens, 13(2), 145.
https://doi.org/10.3390/pathogens13020145
Beshiru, A., Igbinosa, I. H., & Igbinosa, E. O. (2024).
Extended-spectrum beta-lactamase-producing
Escherichia coli in environmental and clinical
settings in Nigeria. Scientific Reports, 14,
https://doi.org/10.1038/s41598-024-
-w
Cheesbrough, M. (2006). District laboratory practice
in tropical countries (Part 2). Cambridge
University Press.
Clinical and Laboratory Standards Institute (CLSI).
(2023). Performance standards for antimicrobial
susceptibility testing (33rd ed.). CLSI
supplement M100.
Green, M. R., & Sambrook, J. (2020). Molecular
cloning: A laboratory manual (4th ed.). Cold
Spring Harbor Laboratory Press.
Hooton, T. M., Roberts, P. L., & Stamm, W. E. (2021).
A prospective study of asymptomatic bacteriuria
in women. New England Journal of Medicine.
Kalu, I. C., Ezemba, C. C., & Okeke, I. N. (2025).
Molecular epidemiology of ESBL-producing
Escherichia coli in sub-Saharan Africa: A
systematic review. Frontiers in Microbiology,
, 1293845.
https://doi.org/10.3389/fmicb.2025.1293845
Kamboj, M., & Sepkowitz, K. A. (2021). Nosocomial
infections in patients with cancer. The Lancet
Oncology, 22(2), e89–e98.
https://doi.org/10.1016/S1470-2045(20)30632-8
Laxminarayan, R., Sridhar, D., Blaser, M., Wang, M.,
& Woolhouse, M. (2020). Achieving global
targets for antimicrobial resistance. Science,
(6302), 874–875.
https://doi.org/10.1126/science.aaf9286
Mahajan, S., Kanwar, N., Morgan, G. M., Mendes, R.
E., Lee, B. R., & Selvarangan, R. (2024).
Antimicrobial susceptibility trends in
Escherichia coli causing urinary tract infections.
Pathogens, 13(12), 1068.
https://doi.org/10.3390/pathogens13121068
Medina, M., & Castillo-Pino, E. (2019). An
introduction to the epidemiology and burden of
urinary tract infections. Therapeutic Advances in
Urology, 11, 1–7.
https://doi.org/10.1177/1756287219832172
Montelin, H., Forsgren, A., & Johansson, A. (2024).
Global spread of ESBL-producing
Enterobacterales: Epidemiology and clinical
implications. Antibiotics, 13(3), 216.
https://doi.org/10.3390/antibiotics13030216
Murray, C. J. L., Ikuta, K. S., Sharara, F., et al. (2022).
Global burden of bacterial antimicrobial
resistance in 2019: A systematic analysis. The
Lancet, 399(10325), 629–655.
https://doi.org/10.1016/S0140-6736(21)02724-0
Nkene, I. H., Ohaegbulam, C. C., & Nworie, A.
(2019). Multiple antibiotic resistance index of
bacterial isolates: A public health tool. Journal
of Infection in Developing Countries, 13(5),
–427.
Shawon, M. M., & Paul, S. K. (2024). Risk factors of
urinary tract infection caused by ESBLproducing bacteria. Journal of Infection and
Public Health.
https://doi.org/10.1016/j.jiph.2024.01.012
Tadesse, B. T., Ashley, E. A., Ongarello, S., et al.
(2020). Antimicrobial resistance in Africa: A
systematic review. The Lancet Infectious
Diseases, 20(2), e29–e45.