Antimicrobial Resistance Profile of Escherichia coli Isolated from Urine of Patients in Selected General Hospitals in Abuja Municipal, Nigeria

Abstract

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 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.