Multidrug Resistance And Susceptibility Profile of Outpatient Escherichia Coli Clinical Isolates

Abstract

Background: To gain better understanding about the impact of antibiotic selection pressure on antimicrobial resistance (AMR) in Nigeria, it is important to conduct and review from time to time the susceptibility profile of clinically important bacteria including Escherichia coli. This study investigated the susceptibility and multidrug resistance profile of E. coli isolates from urine samples of patients who received outpatient’s medical services in Abakaliki. Methods: A total of 50 non-duplicate clinical isolates of E. coli from the microbiology laboratory section of a tertiary hospital in Abakaliki, Nigeria was recruited for this study. Susceptibility studies were determined using amoxicillin (20 µg), ceftazidime (30 µg), ciprofloxacin (5 µg), gentamicin (10 µg), nitrofurantoin (300 µg) and erythromycin acid (15 µg) by the modified Kirby–Bauer disk diffusion method. All susceptibility studies were carried out as per the guidelines of the Clinical Laboratory Standard Institute (CLSI). Multidrug resistance was evaluated by the multiple antibiotic resistance index (MARI) calculation. Results: The E. coli isolates showed reduced susceptibility to gentamicin (75%), ciprofloxacin (85%), nitrofurantoin (95%), amoxicillin (100%), erythromycin (100%) and ceftazidime (95%). A total of 12 E. coli isolates were multidrug resistant to clinically important antibiotics in the classes: cephalosporins, macrolides, aminoglycosides, fluoroquinolones, penicillins and nitrofurantoin. Conclusion: We report a high rate of antibiotic resistance of outpatients E. coli isolates which concurrently showed multidrug resistance to important antibiotic classes. These findings have clinical significance and provide a benchmark for future studies on the susceptibility pattern of clinical isolates in Nigeria. This preliminary study reiterates the need to reinvigorate antibiotic stewardship in our local hospitals so as to preserve the clinical efficacy of available antibiotics since it takes years for a new antibiotic to be developed.