Antibiotics Resistant Profile of Multi Drug Resistance Uropathogenic Escherichia coli in Southeastern Nigeria - Abstract
Objective: To determine the prevalence and antimicrobial resistance pattern of uropathogenic Escherichia coli (E. coli) from patients in a tertiary hospital, in southeastern Nigeria.
Method: This was a cross sectional study carried out at the Medical Microbiology Department of University of Nigeria Teaching Hospital (UNTH) Enugu, in southeastern Nigeria from July 2013 to June 2016. Ethical Clearance was obtained from Health research ethical committee of University of Nigeria Teaching Hospital Enugu. A total of 6553 urine samples were examined and cultured in 5% sheep blood agar and MacConkey agar plate. The plates were incubated aerobically at 37° C for 18 hours. After which E. coli isolates were identified using standard biochemical tests. Antimicrobial resistant testing were done on Muller Hinton plates using modified Kirby-Bauer method and interpreted according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Analytical and descriptive statistics was done using statistical package for the social sciences (SPSS) version.
Result: Out of 6553 urine samples, 2062 showed significant growth with E. coli (65.6%) being the most predominant followed by Klebsiella spp. (19.3%), Proteus spp (6.2%), Pseudomonas aeruginosa (4.7%) and Staphylococcus aureus (3.5%). The age group 30-39 years (27.3%) had the highest prevalence. (?2 =572.1, p= 0.001). Females constituted 81.4 % of the study (?2
=469.43, p< 0.000). The antibiotics that showed yearly increase in resistance were ciprofloxacin, augmentin, amoxicillin, cotrimoxazole, nitrofurantoin, ceftriaxone, gentamicin and ofloxacin. All the isolates had a multiple antibiotics resistance (MAR) index greater than 0.2.
Conclusion: E. coli isolates showed multiple drug resistance to commonly used antibiotics in the treatment of urinary tract infections. Antibiotic guidelines and good practice of antibiotic stewardship is of paramount importance for the optimum care of the patient.