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Eezzeldin, H. M., Badi, S., & Yousef, B. A. (2022). The Antibiotic Resistance and Multidrug Resistance Pattern of Uropathogenic Escherichia coli at Soba University Hospital: A Descriptive Retrospective Survey. Sudan Journal of Medical Sciences (SJMS), 17(1), 56-69. https://doi.org/10.18502/sjms.v17i1.10685
https://doi.org/10.18502/sjms.v17i1.10685
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Hagir Mohamed Eezzeldin
Hagir Mohamed Eezzeldin
Department of Clinical Pharmacy, Faculty of Pharmacy, University of Khartoum, Al-Qasr Ave, Khartoum, Sudan
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Safaa Badi
Safaa Badi
Department of Clinical Pharmacy, Faculty of Pharmacy, Omdurman Islamic University, Aboseid Street, Khartoum, Sudan
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Bashir Alsiddig Yousef
Bashir Alsiddig Yousef
Department of Pharmacology, Faculty of Pharmacy, University of Khartoum, Al-Qasr Ave, Khartoum, Sudan
Published Date
- Mar 31, 2022
The Antibiotic Resistance and Multidrug Resistance Pattern of Uropathogenic Escherichia coli at Soba University Hospital: A Descriptive Retrospective Survey
Abstract
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 out-patients 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 (Chi-square 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, 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.
Keywords:
Escherichia coli, urinary tract infection, multidrug resistance, Soba University Hospital
References
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[27] Morrill, H. J., Morton, J. B., Caffrey, A. R., et al. (2017). Antimicrobial resistance of Escherichia coli urinary isolates in the Veterans Affairs Health Care System. Antimicrobial Agents and Chemotherapy, vol. 61, no. 5, pp. 02236-16.
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[2] Medina, M. and Castillo-Pino, E. (2019). An introduction to the epidemiology and burden of urinary tract infections. Therapeutic Advances in Urology. https://doi.org/10.1177/1756287219832172
[3] Flores-Mireles, A. L., Walker, J. N., Caparon, M., et al. 2015 (). Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nature Reviews Microbiology, vol. 13, no. 5, pp. 269–284.
[4] Alanazi, M. Q., Alqahtani, F. Y., and Aleanizy, F. S. (2018). An evaluation of E. coli in urinary tract infection in emergency department at KAMC in Riyadh, Saudi Arabia: retrospective study. Annals of Clinical Microbiology and Antimicrobials, vol. 17, no. 1, p. 3.
[5] Hooton, T. M. (2012). Clinical practice. Uncomplicated urinary tract infection. New England Journal of Medicine, vol. 366, no. 11, pp. 1028–1037.
[6] Foxman, B. (2014). Urinary tract infection syndromes: occurrence, recurrence, bacteriology, risk factors, and disease burden. Infectious Disease Clinics of North America, vol. 28, no. 1, pp. 1–13.
[7] Nicolle, L. E. and AMMI Canada Guidelines Committee. (2005). Complicated urinary tract infection in adults. Canadian Journal of Infectious Diseases and Medical Microbiology, vol. 16, no. 6, pp. 349–360.
[8] Levison, M. E. and Kaye, D. (2013). Treatment of complicated urinary tract infections with an emphasis on drug-resistant gram-negative uropathogens. Current Infectious Disease Reports, vol. 15, no. 2, pp. 109–115.
[9] Beahm, N. P., Nicolle, L. E., Bursey, A., et al. (2017). The assessment and management of urinary tract infections in adults: guidelines for pharmacists. Canadian Pharmacists Journal, vol. 150, no. 5, pp. 298–305.
[10] Tandogdu, Z. and Wagenlehner, F. M. (2016). Global epidemiology of urinary tract infections. Current Opinion in Infectious Diseases, vol. 29, no. 1, pp. 73–79.
[11] Gupta, K., Hooton, T. M., Naber, K. G., et al. (2011). International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clinical Infectious Diseases, vol. 52, no. 5, pp. e103–e20.
[12] Al Yousef, S. A., Younis, S., Farrag, E., et al. (2016). Clinical and laboratory profile of urinary tract infections associated with extended spectrum beta-lactamase producing Escherichia coli and Klebsiella pneumoniae. Annals of Clinical & Laboratory Science, vol. 46, no. 4, pp. 393–400.
[13] Ikram, R., Psutka, R., Carter, A., et al. (2015). An outbreak of multi-drug resistant Escherichia coli urinary tract infection in an elderly population: a case-control study of risk factors. BMC Infectious Diseases, vol. 15, no. 1, p. 224.
[14] Raeispour, M. and Ranjbar, R. (2018). Antibiotic resistance, virulence factors and genotyping of uropathogenic Escherichia coli strains. Antimicrobial Resistance & Infection Control, vol. 7, no. 118, pp. 018–0411.
[15] Komolafe, O. O. (2003). Antibiotic resistance in bacteria - an emerging public health problem. Malawi Medical Journal, vol. 15, no. 2, pp. 63–67.
[16] Sabir, S., Ahmad Anjum, A., Ijaz, T., et al. (2014). Isolation and antibiotic susceptibility of E. coli from urinary tract infections in a tertiary care hospital. Pakistan Journal of Medical Sciences, vol. 30, no. 2, pp. 389–392.
[17] Foxman, B. (2002). Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. American Journal of Medicine, vol. 8, no. 113, pp. 01054–01059.
[18] Huang, L.-F., Lo, Y.-C., Su, L.-H., et al. (2014). Antimicrobial susceptibility patterns among Escherichia coli urinary isolates from community-onset health care-associated urinary tract infection. Journal of the Formosan Medical Association, vol. 113, no. 12, pp. 970–973.
[19] Murugan, K., Savitha, T., and Vasanthi, S. (2012). Retrospective study of antibiotic resistance among uropathogens from rural teaching hospital, Tamilnadu, India. Asian Pacific Journal of Tropical Disease, vol. 2, no. 5, pp. 375–380.
[20] Alperin, M., Burnett, L., Lukacz, E., et al. (2019). The mysteries of menopause and urogynecologic health: clinical and scientific gaps. Menopause, vol. 26, no. 1, pp. 103–111.
[21] Mukherjee, M., Basu, S., Mukherjee, S. K., et al. (2013). Multidrug-resistance and extended spectrum beta-lactamase production in uropathogenic E. coli which were isolated from hospitalized patients in Kolkata, India. Journal of Clinical and Diagnostic Research, vol. 7, no. 3, pp. 449–453.
[22] Bashir, S., Sarwar, Y., Ali, A., et al. (2011). Multiple drug resistance patterns in various phylogenetic groups of uropathogenic E. coli isolated from Faisalabad region of Pakistan. Brazilian Journal of Microbiology, vol. 42, no. 4, pp. 1278–1283.
[23] Subbalaxmi, M. V., Lakshmi, V., and Lavanya, V. (2010). Antibiotic resistance – experience in a tertiary care hospital in south India. Journal of the Association of Physicians of India, vol. 58, pp. 18–22.
[24] Kheder, S. I. (2011). Cephalosporins usage and resistance trend in a Sudanese hospital surgical wards. Journal of Pharmaceutical and Biomedical Sciences, vol. 11, no. 3, pp. 1–6.
[25] Abdalla, S. N. and Yousef, B. A. (2016). Prescribing patterns of antimicrobials in the Internal Medicine Department of Ibrahim Malik Teaching Hospital in Khartoum. Pan African Medical Journal, vol. 34, p. 89.
[26] Elfaki, A. (2009). Assessment of antibiotics prescription in hospitalized patients at Elobeid Hospital, Sudan. Sudan Journal of Medical Sciences, vol. 4, no. 3, pp. 269–272.
[27] Morrill, H. J., Morton, J. B., Caffrey, A. R., et al. (2017). Antimicrobial resistance of Escherichia coli urinary isolates in the Veterans Affairs Health Care System. Antimicrobial Agents and Chemotherapy, vol. 61, no. 5, pp. 02236-16.
[28] Xie, J., Talaska, A. E., and Schacht, J. (2011). New developments in aminoglycoside therapy and ototoxicity. Hearing Research, vol. 281, no. 1–2, pp. 28–37.
[29] Andriole, V. T. (2005). The quinolones: past, present, and future. Clinical Infectious Diseases, vol. 15, no. 41, p. 428051.
[30] Sanchez, G. V., Baird, A. M., Karlowsky, J. A., et al. (2014). Nitrofurantoin retains antimicrobial activity against multidrug-resistant urinary Escherichia coli from US outpatients. Journal of Antimicrobial Chemotherapy, vol. 69, no. 12, pp. 3259–3262.
[31] Hasan, A. S., Nair, D., Kaur, J., et al. (2007). Resistance patterns of urinary isolates in a tertiary Indian hospital. Journal of Ayub Medical College Abbottabad, vol. 19, no. 1, pp. 39–41.
[32] Sahm, D. F., Thornsberry, C., Mayfield, D. C., et al. (2001). Multidrug-resistant urinary tract isolates of Escherichia coli: prevalence and patient demographics in the United States in 2000. Antimicrobial Agents and Chemotherapy, vol. 45, no. 5, pp. 1402–1406.
[33] Khawcharoenporn, T., Vasoo, S., and Singh, K. (2013). Urinary tract infections due to multidrug-resistant enterobacteriaceae: prevalence and risk factors in a Chicago emergency department. Emergency Medicine International, vol. 2013, article 258517.
[34] Tenney, J., Hudson, N., Alnifaidy, H., et al. (2018). Risk factors for aquiring multidrug-resistant organisms in urinary tract infections: a systematic literature review. Saudi Pharmaceutical Journal, vol. 26, no. 5, pp. 678–684.