Molecular Characterization of Gram Negative Bacteria Involved in Sepsis Among Under Five Children in Akwa Ibom State Nigeria

Sepsis is a life threatening medical emergency, Gram negative bacteria the principal causes of sepsis are seen in higher proportions among pediatrics populations and are mostly antibiotic resistance organisms. This study was carried out to determine antibiotic resistance of Gram negative bacteria, antibiotic resistance genes involve in sepsis among under five children in Akwa Ibom State, Nigeria. A hospital-based descriptive observational study of neonates with or without clinical features of sepsis. The subjects were children seen in General Hospital Ikot Ekpene, University Teaching Hospital Uyo and Immanuel Hospital Eket. A total of 180 children were sampled (60 from each hospital). A two milliliters (2 ml) sterile syringe with a 23gauge needle was used to collect blood sample aseptically from the vein of the arm of the child, inoculated on thioglycollate broth and subculture on MaConkey, blood and chocolate agar. Gram staining, biochemical characterization, antimicrobial susceptibility and resistance of Gram negative bacteria, their resistance genes were done. Of the 180 children, 123 tested positive for bacterial infections. Escherichia coli 25(13.9%), Proteus mirabilis 19(10.6%), Pseudomonas aeruginosa 15(8.3%), Klebsiella pneumoniae 12(6.7%), Serratia ficaria 9(5.0%), Rhizobium radiobacter 8(4.4%), Klebsiella oxytoca 7(3.9%), Chromobacterium violaceum 7(3.9%), Serratia marcescens 5(2.8%), Escherichia fergusonii 4(2.2%), Pseudomonas luteola 3(1.7%), Burkholderia cepacia 3(1.7%), Achromobacter xylosoxidans 3(1.7%), Burkholderia vietnamiensis 2(1.1%) and Serratia odorifera 1(0.6%). Pseudomonas aeruginosa was resistance to the 12 antibiotic used 12(100%), Three isolates were finally selected for molecular analysis, E. coli, P. aeruginosa, K. pneumoniae acquire blaSHV, PAGS, PASS, Cnf1 and hlyC genes, blaTEM amplify Pseudomonas and Klebsiella, FimH amplify only Klebsiella. Gram negative bacteria develop antibiotic resistance which poses a significant challenge in treating infections caused by this organism emphasizing the importance of responsible antibiotic use to mitigate further development of resistance.