Carbapenemase-producing Enterobacteriaceae and Acinetobacter species among pregnant women in Rivers State, Nigeria

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Purpose: To investigate the prevalence, antibiotic resistance profiles, and carbapenemase production among Enterobacteriaceae and Acinetobacter spp. isolated from pregnant women attending selected tertiary hospitals in Rivers State, Nigeria. Methods: This is a cross-sectional study conducted from April to December, 2024, in the University of Port Harcourt Teaching Hospital (UPTH), Rivers State University Teaching Hospital (RSUTH), and Madonna University Teaching Hospital (MUTH). A total of 423 midstream urine samples were collected from consenting pregnant women. The isolates obtained from the urine samples were identified using standard morphological and biochemical procedures. Antimicrobial susceptibility was determined using modified Kirby-Bauer method and interpreted using CLSI standards, while the carbapenemase production was confirmed phenotypically using the Modified Hodge Test (MHT), Triton Hodge Test (THT), and Modified Carbapenem Inactivation Method (mCIM). Results: The 423 samples yielded 170 isolates, including 165 Enterobacteriaceae and 5 Acinetobacter spp. High level of resistance was observed against β-lactam antibiotics, while fluoroquinolones showed moderate activity. The majority showed imipenem resistance and were phenotypically confirmed as Klebsiella pneumoniae carbapenemase or metallo-β-lactamase producers. No significant association (p > 0.05) was observed between isolate distribution and demographic factors. Conclusion: The detection of multidrug-resistant (MDR) and carbapenemase-producing Enterobacteriaceae and Acinetobacter spp. among pregnant women in Rivers State emphasises the need for antimicrobial stewardship and molecular surveillance programmes.

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