Molecular characterization of extended-spectrum beta-lactamase-producing bacteria isolated from pregnant women’s urine at Itojo Hospital, South Western Uganda

Abstract

<b>Background.</b> Extended-spectrum <i>β</i>-lactamase (ESBL)-producing bacteria pose a global challenge because of resistance developing against a wide range of antimicrobial agents, complicating available treatment options. Thus, identifying the prevalent bacterial species producing ESBL enzymes and understanding how they are susceptible to antibiotics is necessary to inform effective treatment guidelines. <b>Objective.</b> We sought to characterize ESBL-producing bacteria isolated from pregnant women's urine at Itojo Hospital, Ntungamo district, Southwestern Uganda. <b>Methods.</b> We conducted a cross-sectional study where we collected and analysed 340 urine samples from 340 pregnant women. We did antimicrobial susceptibility testing using the Kirby-Bauer disc diffusion method. Isolates were screened for ESBL production and confirmed using the combination disc test. Genotypic characterization was confirmed using multiplex PCR to detect <i>bla</i>TEM, <i>bla</i>CTX-M and <i>bla</i>SHV genes. <b>Results.</b> The prevalence of ESBL-producing bacteria was 29.7% (101/340). <i>Escherichia coli</i> 36/101 (35.6%) and <i>Klebsiella</i> species 33/101 (32.7%) were predominant ESBL producers. Genotypic analysis revealed <i>bla</i>TEM 50/101 (49.5%) and <i>bla</i>CTX-M 31/101 (30.7%) as the most prevalent genes, while <i>bla</i>SHV was less common, 8/101 (7.9%) <b>Conclusion.</b> The high prevalence of ESBL-producing bacteria and their resistance to commonly used antibiotics highlighted the need for targeted antibiotic therapy, antimicrobial stewardship and regular molecular surveillance.