The prevalence of multiple drug resistance Escherichia coli and Klebsiella pneumoniae isolated from patients with urinary tract infections

Purposes

Urinary tract infections (UTIs) and bacterial resistance to antibiotics is a global health problem and a threat to public health in many countries. UTIs are frequently attributed to bacterial infections caused by either Gram-negative bacteria or Gram-positive bacteria. The study aimed to determine the prevalence of MDR Escherichia coli and Klebsiella pneumoniae in UTI patients and to determine antibiotic resistance pattern for risk assessment for recurrent UTIs, and help to facilitate the appropriate antibiotic selection for UTIs.

Methods

The midstream urine samples of 120 patients were collected and cultured as described by the protocols at the respective sample collection sites on MacConkey Blood agar. Samples were tested by using the fully automated VITEK 2 Compact system for Gram-negative identification and detection of antimicrobial susceptibility of microorganisms.

Results

The most prevalent pathogen was E. coli which was found in 82 (68.3%) urine isolates, followed by K. pneumonia, found in 38 (31.7%) urine isolates. As far as antibiotic resistance is concerned, E. coli isolates were found to be highly resistant for Ceftriaxone (89.0% of the isolates), Ampicillin (86.6%), Levofloxacin (82.9), Cefotaxime (79.3%), Aztreonam (74.4%), Ceftazidime (68.3%) and for Gentamicin, Piperacillin, and Trimethoprim-Sulfamethoxazole, 54.9 and 53.7% respectively. The E. coli isolates were found to be relatively less resistant for Imipenem, Cefepime, and Ciprofloxacin which was2.4%, 34.1% and 35.4 % respectively. K. pneumonia isolates were found to be highly resistant for Piperacillin, Levofloxacin, Ampicillin, Cefotaxime, Trimethoprim-Sulfamethoxazole, Cefotaxime, Ceftazidime, Gentamicin, Cefepime, and Aztreonam which was 81.6%, 78.9%, 76.3%, 73.7%, 71.1%, 65.8%, 63.2%, 50.0% and 44.7% respectively. But, these were found to be less resistant for Imipenem, Ceftriaxone, and Ciprofloxacin which was 13.2%, 31.6% and 36.8 % respectively.

Conclusions

E. coli and K. pneumoniae from the clinical isolates displayed high resistance to many antibiotics in UTI patients.