Opening Pandora box - high level resistance to antibiotics of last resort in Gram negative bacteria from Nigeria

Abstract

Antimicrobial resistance (AMR) is a global problem but information about the prevalence and mechanisms of resistance in sub-Saharan Africa are lacking. We determined the percentage of drug resistant isolates and resistance mechanisms in 307 Gram negative isolates randomly collected from south western Nigeria. Susceptibility testing revealed 78.1%, 92.2% and 52.6% of all isolates were resistant to fluoroquinolones, third generation cephalosporins and carbapenems respectively. There were more resistant isolates from the stools of uninfected patients than from specimens of patients with symptoms of infections. Only a small proportion of E. coli (10%) and Klebsiella (7%) isolates produced a carbapenemase. Whole genome sequencing of selected isolates identified the presence of globally disseminated clones. This depicts a crisis for the use of first line therapy in Nigerian patients, it is likely that Nigeria is playing a significant role in the spread of AMR due to her high population and mobility across the globe.