Prevalence of Multi-drug Resistance Pattern of Escherichia coli in Different Ages and Gender of Urinary Tract Infected Patients

Abstract

Aims: To find out the prevalence of multi-drug resistance pattern of Escherichia coli in urinary tract infected patients in Dhaka, Bangladesh. Study Design: The study was influenced by recurrent urinary tract infections (UTIs) and presence of high multi-drug resistant (MDR) E. coli. Place and Duration of Study: Department of Microbiology, Primeasia University, Institute of Laser Surgery and Hospital, Millennium Heart & General Hospital, between January to December 2017. Methodology: Total 605 patients (age range <1-80 years) were included as sample populations. Followed by overnight enrichment of urine samples in LB medium at 37ºC, isolates were confirmed as uropathogenic E. coli (UPEC) by using selective media and biochemically through oxidase, indole and citrate test. All the isolates were examined for antibiotic susceptibility to fifteen commonly used antimicrobial agents by disk diffusion assay on Mueller Hinton agar results were interpreted by following the guideline of Clinical and Laboratory Standards Institute (CLSI). Result: About 38% (230 out of 605) UPEC have been screened out. Prevalence of E. coli was observed high (58%) in female patients and the most vulnerable age group was (50-80) which showed approximately 63% presence of UPEC. Almost 100% isolates have become considered as multi-drug resistant (>5 drugs). All the isolates showed 100% resistance against rifamicin, while no resistance was observed against colistin. Statistically, antibiotic resistance of UPEC against meropenem and amikacin was significant within male and female. Most alarming resistance have been observed against commonly prescribed antibiotic, 4th generation cephalosporin (cefipime) and ciprofloxacin were 95% and 74% respectively, 3rd generation cephalosporin (ceftriaxone 97%, cefixime 90%, ceftazidime 83%). At the same time 94% isolates showed resistance to vancomycin, 89% to piperacillin, 91% to azithromycin, 87% to gentamicin, 66% to nitrofurantoin, 59% to amikacin, 47% to meropenem and 45% to imipenem. Conclusion: This finding is useful for the determination of appropriate antimicrobial treatment in UTI patients.