Multidrug resistant Escherichia coli strains isolated from urine sample, University of Gondar Hospital, Northwest Ethiopia (original) (raw)
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International Journal of Research in Medical Sciences, 2023
Background: Multi-drug resistant organisms, particularly in urinary tract infections, have become a significant concern in developing countries like Bangladesh. Physicians are facing challenges in treating hospitalized cases due to the ineffectiveness of conventional antibiotics and empirical treatment, as well as the emergence of multi-drug-resistant Escherichia coli. The main goal of the study was to observe the prevalence and resistant pattern of multidrug-resistant Escherichia coli urinary tract infections among patients admitted to a teaching hospital. Methods: The cross-sectional study was conducted between August 2011 to February 2012 at Uttara Adhunik Medical College Hospital (UAMCH), Dhaka, Bangladesh. It included 100 cases, and detailed information was obtained through a standardized protocol. Results: In a study of 100 UTI patients, 45 had MDR E. coli while 55 had non-MDR E. coli. Females accounted for 79% of the patients, with a mean age of 44.85±17.81 years. The majority of participants fell into the 31-40 years age group (28%) and 60 years age group (23%). Among the participants, 57% had a history of UTI while 43% had no previous UTI history. High resistance was observed against amoxicillin, amoxiclav, cephradine, cefuroxime, cefixime, ceftriaxone, ceftazidime, and nalidixic acid. However, ciprofloxacin (2.22%), levofloxacin (6.67%), and cotrimoxazole (31.11%) exhibited lower resistance rates among MDR samples. Imipenem and meropenem showed 100% effectiveness against all MDR samples. Conclusion: MDR E. coli rates were alarmingly high in a teaching hospital in Bangladesh. Excessive antimicrobial drug consumption globally has led to antibiotic-resistant E. coli isolates, posing challenges for effective UTI treatment worldwide. Antibiotic therapy remains crucial in controlling these invasive agents.
Sudan journal of medical sciences, 2022
Background: The irrational use of antibiotics for the treatment of urinary tract infections (UTIs) may lead to increased antimicrobial resistance among uropathogenic Escherichia coli (E. coli), as well as multidrug resistance worldwide, which will limit available treatment options for UTIs caused by these organisms. This study aimed to determine the resistance pattern of E. coli causing UTIs in outpatients and in-patients of Soba University Hospital. Methods: Data were collected from the laboratory records in the Department of Microbiology in Soba Teaching Hospital by using a predesigned checklist and then analyzed using the statistical package for social sciences. Bivariate analysis (Chisquare test) was used to compare between variables. Results: Out of the 231 E. coli urine cultures, 160 (69.3%) were collected from females. The results showed high resistance to ampicillin (92.4%), amoxicillin-clavulanic acid (83.3%), cephalexin (90.6%), cefuroxime (72%), ceftazidime (71%), ceftriaxone (72%), ciprofloxacin (68%), and co-trimoxazole (75.3%). Collectively, around 188 (81.4%) were multidrug-resistant. On the other hand, the sensitivities of E. coli isolates were 68.8%, 93.1%, 89.4%, and 100% to gentamicin, amikacin, nitrofurantoin, and carbapenems, respectively. Conclusion: The rate of E. coli resistance was observed to be high to the commonly prescribed drugs for UTIs, including ampicillin, amoxicillin/clavulanic acid, different cephalosporins, fluoroquinolones, and co-trimoxazole. However, E. coli showed lower resistance rates to nitrofurantoin, amikacin, and carbapenems. Thus, these drugs can be reserved for the empirical treatment of UTIs caused by E. coli.
Increased multi-drug resistant Escherichia coli from hospitals in Khartoum state, Sudan
African Health Sciences, 2013
Background: Multidrug-resistant Escherichia coli (MDR E. coli) has become a major public health concern in Sudan and many countries, causing failure in treatment with consequent huge health burden. Objectives: To determine the prevalence and susceptibility of MDR E. coli isolated from patients in hospitals at Khartoum State. Methods: Between May to August 2011, E. coli (n = 232) isolated from clinical specimens, identified, tested their antimicrobials susceptibility and screened for extend spectrum â-lactamase production as per standard methods. Results: Of the 232 E. coli isolates, the majority were from urine (65.1%). MDR E. coli were present in 214 (92.2%). Of these, the resistance rates were recorded to: amoxicillin 97.7%, cefuroxime 92.5%, trimethoprim-sulfamethoxazole 88.3%, tetracycline 77.1%, nalidixic acid 72%, ceftriaxone 64%, ciprofloxacin 58.4%, ofloxacin 55.1%, amoxicillin-clavulanate 50.4%, ceftazidime, gentamicin 35% each, nitrofurantoin 22.4%, chloramphenicol, tobramicin 18.2% each and amikacin 1.9%. Overall MDR E. coli, 53.3% were resistant to > 7 antimicrobial agents and ESBL was detected in 32.7%. Isolates from males were more resistant than those from females (p < 0.05). Conclusions: Drug-resistance surveillance and epidemiological analysis of patient data is need periodically and can be informative for appropriate management of antimicrobial resistance.
2011
Concurrent resistance to antimicrobials of different structural classes has arisen in a multitude of bacterial species and may complicate the therapeutic management of infections, including those of the urinary tract. To assess the current breadth of multidrug resistance among urinary isolates of Escherichia coli, the most prevalent pathogen contributing to these infections, all pertinent results in The Surveillance Network Database-USA from 1 January to 30 September 2000 were analyzed. Results were available for 38,835 urinary isolates of E. coli that had been tested against ampicillin, cephalothin, ciprofloxacin, nitrofurantoin, and trimethoprim-sulfamethoxazole. Of these isolates, 7.1% (2,763 of 38,835) were resistant to three or more agents and considered multidrug resistant. Among the multidrug-resistant isolates, 97.8% were resistant to ampicillin, 92.8% were resistant to trimethoprim-sulfamethoxazole, 86.6% were resistant to cephalothin, 38.8% were resistant to ciprofloxacin, and 7.7% were resistant to nitrofurantoin. The predominant phenotype among multidrug-resistant isolates (57.9%; 1,600 of 2,793) included resistance to ampicillin, cephalothin, and trimethoprim-sulfamethoxazole. This was the most common phenotype regardless of patient age, gender, or inpatient-outpatient status and in eight of the nine U.S. Bureau of the Census regions. Rates of multidrug resistance were demonstrated to be higher among males (10.4%) than females (6.6%), among patients >65 years of age (8.7%) than patients <17 (6.8%) and 18 to 65 (6.1%) years of age, and among inpatients (7.6%) than outpatients (6.9%). Regionally, the rates ranged from 4.3% in the West North Central region to 9.2% in the West South Central region. Given the current prevalence of multidrug resistance among urinary tract isolates of E. coli in the United States (7.1%), continued local, regional, and national surveillance is warranted.
The prevalence and antibiotic susceptibility pattern of E. coli was analyzed in urine samples of patients with acute and recurrent urinary tract infection visiting a diagnostic laboratory in Lahore. The prevalence of MDR strains of E. coli among the isolates was also determined. A total of 310 isolates (73.1%) of E. coli were obtained from 424 positive culture isolates. The highest percentage of the isolates was present in the age group of 51-75 years in both males and females (30.9% and 9.6% respectively). Females were more frequently affected (77.4%) as compared to males (22.5%, P < 0.02). E. coli showed highest sensitivity towards Imipenem (100%), Meropenem (99.3%), Piperacillin/Tazobactum (96.8%), Amikacin (89.7%), Cefoperazone/Sulbactum (86.8%), Ceftazidime (77.2%), Gentamicin (73.2%), and Aztreonam (67.1%). 65.5% of isolates were resistant to more than 8 drugs, belonging to 3 or more than 3 different classes of drugs.
Y.B. Ngwai, 2018
This study investigated the antimicrobial resistance profile of Escherichia coli from urine of patients with suspected urinary tract infections (UTIs) in selected general hospitals in Abuja Municipal, Nigeria. Four Hundred and Thirty urine samples were collected between September 2017 and May 2018 from patients attending Asokoro General Hospital (AGH), Garki Hospital Abuja (GHA) and Wuse General Hospital (WGH); and E. coli was isolated and identified by culture, microscopy and biochemical tests. The overall occurrence of E. coli was 52 (12.1%). The occurrences in relation to the hospitals were of the order: GHA (14.7%) > WGH (12.6%) > AGH (9.0%). The highest (50%) occurrence was at age 41-50 years in WGH, and the lowest (4.3%) was at age 31-40 years in Original Research Article Eghieye et al.; AJARR, 2(2): 1-10, 2018; Article no.AJARR.44668 2 AGH. More females than males harboured the bacteria in all the hospitals. Isolates from AGH showed highest (100.0%) resistance to Sulphamethoxazole/Trimethoprim but least (0.0%) resistance to Ciprofloxacin. Isolates from GHA showed the highest resistance to Cefotaxime and Streptomycin (95.2%) but least (23.8%) to Gentamicin and Imipenem. Isolates from WGH showed highest (88.8%) resistance to Amoxicillin/Clavulanic Acid but least (16.7%) to Sulphamethoxazole/Trimethoprim. The commonest antibiotic resistance phenotype in AGH was Amoxicillin/Clavulanic Acid-Streptomycin-Cefotaxime-Ceftazidime-Imipenem-Ampicillin (3.9%); in GHA was Amoxicillin/Clavulanic Acid-Streptomycin-Sulphamethoxazole/Trimethoprim-Cefotaxime-Ceftazidime-Ampicillin (7.7%); and in WGH was Amoxicillin/Clavulanic Acid-Streptomycin-Cefotaxime-Cefotaxime-Ceftazidime-Imipenem-Ampicillin (3.9%). All the isolates had MAR indices above 0.2; the most common index in AGH was 0.4 (at 30.8%), GHA was 0.7 (at 33.3%) and WGH was 0.7 (at 27.8%). The commonest class of antibiotic resistance was MDR with the order of occurrence as: GHA (92.2%) > WGH (77.7%) > AGH (76.6%). Ciprofloxacin, gentamicin and imipenem were the most effective antibiotics in the study location. However, MAR indices in this study have shown that the isolates originated from an environment where antibiotics are freely available and misused/abused. Hence, there is a need for greater monitoring of antibiotic supplies and use.
High prevalence of multidrug-resistance uropathogenic Escherichia coli strains, Isfahan, Iran
Journal of Natural Science, Biology and Medicine, 2016
Background and Objectives: Urinary tract infection (UTI) is one of the most frequent infectious diseases and can occur in all age groups. Escherichia coli is the main cause of this infection. Multiple resistances to antimicrobial agents are increasing quickly in E. coli isolates and may complicate therapeutic strategies for UTI. The aim of this study was to determine the antibiotic resistance pattern and the multidrug-resistance (MDR) phenotypes in uropathogenic E. coli (UPEC). Materials and Methods: A total of 135 UPEC isolates were collected from both outpatients (91 isolates) and inpatients (44 isolates) between September, 2012 and February, 2013. In order to determine the MDR among UPEC isolates, we have tested 15 antimicrobial agents and antibiotic susceptibility was done by Kirby-Bauer disk diffusion method. Results: The percentage of MDR isolates (resistant to at least three drug classes such as aminoglycosides, fl uoroquinolones, penicillins, cephalosporins, or carbapenems) was 68% in the inpatients and 61% in the outpatients. Antibiotic resistance to ampicillin, ceftazidim, nalidixic acid, and trimethoprim/sulfamethoxazole were higher than 50%. Amikacin, nitrofurantoin, and gentamicin showed markedly greater activity (89.1%, 85.9%, and 82.4% sensitivity, respectively) than other antimicrobial agents. Resistance to meropenem did show either in outpatients or in inpatients. Interpretation and Conclusions: The high prevalence of drug resistance among UTI patients calls for continuous monitoring of the incidence of drug resistance for appropriate empiric selection of antibiotic therapy. Empirical treatment of UTIs should be relied on susceptibility patterns from local studies.
Y.B. Ngwai, 2018
Aim: This study investigated antimicrobial resistance in E. coli recovered from urine of patients attending Nagari Allah Magani Hospital, Keffi, Nigeria. Place and Duration of Study: Methodology: Escherichia coli was isolated and identified from the urine of suspected UTIs patients by culture, microscopy and biochemical tests. Sample: We included 248 patients; (116 Original Research Article Eko et al.; AJRIMPS, 5(4): 1-9, 2018; Article no.AJRIMPS.45728 2 men, 132 women;age range 5-65 years). Antimicrobial Susceptibility Testing of the isolates was carried out in accordance with the Clinical and Laboratory Standards Institute (CLSI) method. Results: Out of 248 samples, the occurrence of E. coli was 43(17.3%). The occurrence of isolates in relation to age of patients was highest in 21-30 year old (26.5%) and lowest in 11-20 year olds (9.5%). The occurrence of the isolates was higher in females (21.2%) than males (12.9%). The isolates were less resistant to imipenem (20.9%), gentamicin (34.9%) and ciprofloxacin (37.3%). The commonest resistance phenotype was Amoxicillin/Clavulanic Acid-Streptomycin-Sulfamethoxazole/Trimethprim-Cefotaxime-Ceftazidime-Cefoxitin-Ciprofloxacin-Ampicillin with an occurrence of 7.0%. Most of the isolates showed multiple antibiotic resistance (MAR) Index of above 0.2 with the commonest MAR Index being 0.6 (23.8%). Most (95.6%) of isolates were classified into multidrug resistance (MDR), a few (2.3%) were non-MDR or pan drug resistance (PDR), and no extensive drug resistance (XDR) was isolated. The occurrence of classes of antibiotic resistance was of the order: MDR (95.3%) ˃ NMDR = PDR (2.3%) > XDR (0.0%). Conclusion: Resistance was less to imipenem, gentamicin and ciprofloxacin antibiotics. Most isolates originated from an environment where antibiotics are freely available and misused or abused; and are MDR isolates. Further work to detect antibiotic resistance genes in the study location should be carried out.
Journal of Community Medicine and Public Health Research, 2020
Pathogenic bacteria cause Urinary Infection imore or lessi about 85 - 95% are bacteria Escherichia coli. The treatment of Urinary Tract Infection (UTI) requires adequate supportive therapy and antibiotics, but antibiotic resistance is an obstacle in UTI treatment. This study aims to determine the types of antibiotics that are resistant to Escherichia coli in patients with UTI. This is an observational study with a descriptive method to determine the type of antibiotic-resistant to Escherichia coli in patients with UTI in the Laboratory of Clinical Microbiology RSUD Dr. Soetomo. Antibiotics that were resistant to Escherichia coli in UTI patients were cefazolin (80.49%), Amoxicillin Clavulanic Acid (73.17%), Ampicillin (73.17%), Tetracycline (68.29%), while antibiotics that were resistant to Escherichia coli ESBL was Amoxicillin Clavulanic Acid (100%), Ampicillin (100%), Cefazolin (99.7%), Aztreonam (99.7%), Ceftazidime (99.7%). The prevalence of Escherichia coli in UTI patients was 2...
Resistance Patterns of Multi-Drug Resistant Escherichia Coli Causing Urinary Tract Infection
International Journal of Research -GRANTHAALAYAH, 2020
480 mid-stream urine samples were collected from outpatients and inpatients attending Tobruk Medical Center. 300 samples gave positive culture, 162 of these were Escherichia coli. The strains sensitivity to 14 antibiotics was tested. High incidence of resistant strains, high degree of association between resistance and complex resistance patterns of the same strains is seen. The strains were resistant to Ampicillin, Penicillin, Erythromycin, Cephalexin and Sulfamethoxazole with 91.9%, 90.7%, 82.7%, 76.5% and 57.4% respectively. The strains were sensitive to Neomycin, Oxacillin and Nitrofurtoin with 100%, 99% and 83% respectively. A symmetrical result for all strains resistance to indicated pairs of drugs were obtained. Strong association between most antibiotic occurred.