Antibacterial-Resistant Genes (Abrg) Associated with Bloodstream Infections in Patients Receiving Treatment at Nigeria Airforce Medical Center Onikan, Lagos State

Abstract

Chigozie C Ukachukwu, Uzochukwu G. Ekeleme*, Chimezie C. Iwuala, Ugonma Winnie Dozie, Christopher Chike A. Okereke, Grace I. Chukwuemeka, Queeneth C. Onuoha, Ezejindu Cosmas Nnadozie, Barthlomew Chigozie Agina, Chidinma O. Akanazu, Chiamaka C. Ogujiuba, Ugonma Winnie Dozie, Chinwendu L. Opara, Valentine Nnachetam Unegbu, Amarachi B. Nwokoro and Nwankwo Ifeanyichukwu Wilson

Background/Objectives: The antibacterial-resistant genes (ABRG) associated with bloodstream infections in patients (BSI-PAP) receiving treatment at the Nigerian Air Force Medical Centre, Onikan, Lagos State, were studied from October 2023 to June 2024. BSI-PAP was defined as bloodstream infections diagnosed within 48 hours of hospitalization.

Methods: Blood samples were analyzed for bacterial contamination and antibiotic resistance, adhering to standard microbiological protocols.

Results: The prevalence of BSI-PAP was found to be at 9.5%. The likelihood of being admitted with BSI-PAP was highest among patients with diabetes mellitus, previous hospitalization, renal failure, and chronic dermatitis. The odds ratios (OR) with 95% confidence intervals (CI) were as follows: Diabetes mellitus: OR = 4.96 (95% CI = 1.37–7.32), previous hospitalization: OR = 2.59 (95% CI = 0.29–4.9), renal failure: OR = 2.39 (95% CI = −0.17–4.89), chronic dermatitis: OR = 1.32 (95% CI = 0.37–4.29). Among the patients admitted with BSI-PAP, the following bacterial species were identified: S. scuri ssp. lentus (35.3%), S. gallinarum (17.6%), S. eqourum (17.6%), E. cloacae ssp (11.8%), B. capacia complex (5.9%), S. xylulosus (5.9%), C. freundi (5.9%). Gram-negative bacteria accounted for a greater proportion of BSI cases (56.7%) compared to gram-positive bacteria (43.3%). Approximately 76% of BSI-PAP cases with these organisms exhibited antibiotic resistance. Resistance to erythromycin, sulfamethoxazole, ciprofloxacin, and ampicillin was most prevalent in patients aged 30 years. A high prevalence of resistant genes was observed, including TEM, CTX-M, SHV, and VEB types. The bacterial isolates (S. scuri ssp. lentus, S. gallinarum, S. eqourum, and S. xylulosus) demonstrated high antimicrobial resistance to commonly prescribed antibiotics, particularly gentamicin, erythromycin, sulfamethoxazole, and tetracycline.

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