Antibacterial-Resistant Genes (ABRG) Associated With Bloodstream Infections In Patients Receiving Treatment: A Case Study Of Nigeria Airforce Medical Center Onikan, Lagos State

Introduction : 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 BSI diagnosed within 48 hours of hospitalization. Methods : Hospital waste samples were analyzed for bacterial contamination and antibiotic resistance adhering to microbiological standards. Results : The prevalence of BSI-PAP was 30 out of 315 discharges (9.5%). The likelihood of being admitted with BSI-PAP was greatest in patients with diabetes mellitus, previous hospitalization, renal failure, and chronic dermatitis. The odds ratios with 95% confidence intervals (CI) were 4.96 (95% CI = 1.37-7.32), 2.59 (95% CI = 0.29-4.9), 2.39 (95% CI = −0.17-4.89), and 1.32 (95% CI = 0.37-4.29). Among the patients admitted with BSI-PAP who were tested with culture media with one of the seven organisms examined (n = 30), the largest proportion had S. scurissp Lentus (n = 6, 35.3%), followed by S. gallinarum (n = 3, 17.6%), S. eqourum (n = 3, 17.6%), E. cloacae SSP (n = 5, 11.8%), B. capacia complex (n = 7, 5.9%), S. xylulosus (n = 1, 5.9%), and C. freundi (n = 5, 5.9%). Approximately 76% (13) of BSI-PAP cases with these organisms had antibiotic-resistant. In general, 86% of individuals examined with SSA culture media had antibiotic-resistant strains, while 78% had EMB and 75% MAC strains (p = 0.0001). Gram-negative bacteria were more frequently involved in BSI in this study (56.7%) than gram-positive bacteria (43.3%). The most frequently isolated bacterium was B. cepacia complex (23.3%); others in descending order were as follows: S. scuri ssp. lentus (20%), E. cloacae ssp., and C. freundi (16.7%). S. gallinarum and S. equourum (10%) and S. xylulosus (3.3%). The drug resistance pattern of gram-positive isolates; Gentamicin Erythromycin and Erythromycin Sulfamethoxazole Tetracycline resistance phenotypes were most common in patients aged 18 to 29 years (54%), while among the gram-negative isolates. Erythromycin, sulfamethoxazole, ciprofloxacin and ampicillin resistance phenotypes were most common in the 30-year-old age group. Erythromycin (85%), gentamicin (55%), sulfamethoxazole (54%), and tetracycline (24%) were commonly used to treat BSI in younger adults, while erythromycin (96%), ciprofloxacin (72%), tetracycline (66%), and ampicillin (60%) were mainly used by middle-aged patients and are easily available without medical authorization. The high antimicrobial resistance has been demonstrated in clinical bacterial isolates ( S. scuri ssp. lentus, S. gallinarum, S. eqourum, and S. xylulosus ) of BSI-PAP to commonly prescribed antibiotics, particularly gentamicin, erythromycin, sulfamethoxazole, and tetracycline. There was a high prevalence of resistant genes of TEM, CTX-M, SHV, and VEB types.