International Journal of Research and Innovation in Applied Science (IJRIAS) | Volume IV, Issue VII, July 2019|ISSN 2454-6194 www.rsisinternational.org Page 70 Prevalence of Extended Spectrum Beta-Lactamase- Producing Escherichia Coli Isolated from Selected Health Facilities in Makurdi Abba, P. O.* 1 , Umeh, E. U. 2 , Gberikon, G. M. 2 and Agbo, E. B. 3 1 Department of Medical Microbiology and Parasitology, Benue State University Teaching Hospital, Makurdi, Benue State, Nigeria. 2 Department of Microbiology, Federal University of Agriculture, Makurdi, Benue State, Nigeria. 3 Department of Microbiology, AbubakarTarfawaBalewaUniversity, Bauchi, Bauchi State, Nigeria. * Corresponding Author Abstract:-The worldwide prevalence of extended-spectrum-beta- lactamase -producing Enterobacteriaceae (ESBL-E) is increasing, making the need for ESBL detection more urgent. In this study we investigated the presence of ESBL in 400 isolates of Escherichia coli from urine, stool, blood, wound swabs, throat swabs and sputum specimens collected from 6 selected health facilities (2 primary, 2 secondary and 2 tertiary) in Makurdi local government council.Standard microbiological methods were used for isolation, characterization and identification of E. coli. The presence of ESBL was determined using the double disc synergy method. Disc susceptibility test was performed on all isolates using standard techniques.The isolates showed high level of resistance to all the antibiotics tested except mipenem. Highest resistance was to penicillin 392(98.0%) followed by ceftriaxone 385(96.3%). The isolates showed least resistance to mipenem 02(0.5%). Out of the 400 isolates examined, 64 (16.0%) carried ESBL genes. Isolates from blood specimens (n = 5; 26.3%) harboured the highest percentage of ESBL genes followed by wound swabs isolates 9(17.3%). No ESBL gene was recovered from throat swabs (n = 0; 0.0%). There exists no significant difference between ESBL-producing E. coli andvarious clinical specimens (p > 0.05).Among the males, isolates from those between 45.0 and 58.0 years old harboured the highest percentage (18.8%; n= 6) of ESBL-producing E. coli isolates, while among the females, those within the age group 31.0 to 44.0 years harboured the highest percentage (25.0%; n=13). Benue State University Teaching Hospital (BSUTH),a tertiary care facility harboured the highest percentage of ESBL-producing Escherichia coli isolates, 29 (19.7%) and was followed by General Hospital (GH) 10(18.9%) which is a secondary care facility. There is no significant association between ESBL and health facilities (p=0.39). Key words: ESBL, Antibiotic resistance Beta-lactamase, Makurdi, Escherichia coli. I. INTRODUCTION xtended Spectrum b-lactamases (ESBLs) are mutant, plasmid-mediated b-lactamases which are derived from older, broad-spectrum β-lactamases (e.g., TEM-1, TEM-2, SHV-1). They have extended substrate profile which allows hydrolysis of all cephalosporins, penicillins, and aztreonam (Philliponet al., 1989). Clinical outcome data indicates that ESBLs significantly complicates therapeutic procedures when involved in infections and they lead to increased mortality. When detected they always indicate the need for use of appropriate antibacterial agents. Failure to detect ESBL production by routine disk-diffusion tests has been well documented (Tenoveret al., 1999; Paterson et al., 1999). Many clinical laboratories are not fully aware of the importance of ESBLs and how to detect them; laboratories may also lack the resources to detect these resistance mechanisms. This lack of understanding or resources is responsible for a continuing failure to respond appropriately to prevent the rapid worldwide dissemination of pathogens possessing these b-lactamases. The consequence has been avoidable therapeutic failures in patients who received inappropriate antibiotics (Venezia et al., 1995). Risk factors that have been associated with ESBL production include old age (> 65 years), gender, previous use of β-lactam antibiotics and fluoroquinolones, (Knusden et al., 2014). Antibiotics use in Nigeria is unregulated and antibiotics are sold freely over the counter without prescriptions (Okeke et al., 1999). Where they are prescribed, extended–spectrum cephalosporins and fluoroquinolones are widely prescribed and used as broad–spectrum antibiotics and remain the drugs of choice to treat infections caused by various Gram negative pathogens (Ogbolu et al., 2011). These indicate that ESBL producing organisms may be present in Nigeria. A previous study from Benin City, Southern-Nigeria reported a prevalence of 2.7 % of ESBL-producing Gram negative bacteria from blood stream infections and surgical wounds (Omoregie et al., 2010). A more recent study from Benin – City by Ogefereet al. (2015) reported a prevalence 44.3%. Another study by Ogbolu et al. (2010) reported a prevalence of 20.9% of ESBL-producing organisms from South-West Nigeria. The prevalence of ESBLs-producing bacteria is unknown in this region; therefore, this current study aimed at evaluating the prevalence of ESBL-producing Escherichia coli from selected health facilities, using a phenotypic detection E