Multi-drug resistant Escherichia Coli isolated from patients with urinary tract infection

Abstract

Urinary tract infections (UTI) are among the most common infectious diseases in the world. They are caused by micro-organisms that infect the structures of the urinary tract. Almost 95% of all UTIs are caused by bacteria and majority of them are caused by E. coli. Due to emergence of resistance strains, UTI infections caused by E. Coli are becoming complicated day by day. Since most UTIs are treated empirically without any culture or sensitivity testing, there is clear knowledge gap about the existing patterns of resistance among our population. Hence, the aim of this study is to identify the drug resistance pattern of E. coli isolated from patients with urinary tract infections. In this cross-sectional study, secondary data were collected from a laboratory in the city of Chattogram. A total of 400 culture and sensitivity reports of urine were collected over a period of two years. Only the reports that came positive for E. Coli were included in this study. Among all the samples, that were included in this study, 383(95.7%) sample isolates showed resistance to at least three antibiotics. Around 22.5% (n=90) of the samples showed antimicrobial resistance to six drugs combinations. Among different combinations of drugs, around 35 sample isolates were resistant to the drug combination of Ampicillin-Cefuroxime-Ceftriaxone- Cefepime- Nalidixic Acid and Ciprofloxacin. It was the most frequent pattern. This study could not find any association between antibiotic resistance pattern and age. In case of gender, male population were significantly more resistant against antibiotics like Meropenem, Imipenem, Amikacin, Gentamycin and Nitrofurantoin as compared to the females. Escherichia Coli is the most frequent uropathogen to date. However, the choice of treatment is gradually becoming narrow due to the widespread resistance of previously used antibiotics. In such circumstances, strict policies should be implemented for prescribing and selling antibiotics. Additionally, regular surveillance is necessary to monitor the organisms that cause UTI along with their resistance patterns. Since the sensitivity patterns of E. coli differ based on geographical locations, susceptibility of the organism and its drug resistance pattern in different region must be studied for an effective treatment against the contagion