Drug resistance and plasmid profile of uropathogenic Escherichia coli among urinary tract infection patients in Addis Abeba

Abstract

Introduction: Urinary tract infection is a major cause of morbidity and mortality worldwide. Uropathogenic Escherichia coli bacteria are the most common cause of urinary tract infections. Drug resistant Escherichia coli is results in high levels of treatment failure and can be a significant threat to survival of patients.

Methodology: Escherichia coli bacteria were isolated using culture and conventional biochemical tests. Antimicrobial susceptibility testing and plasmid profile were performed using the Kirby Bauer disc diffusion method and plasmid analysis. Data was processed with SPSS version 16.0 and Epi-info version 3.4.1 software.

Results: The highest proportion of Escherichia coli isolates was resistant to (86.5%) to ampicillin, followed by ceftazidime (84%), ceftriaxone (80.5%), tetracycline (80%), trimethoprim-sulfamethoxazole (68.5%) and cefotaxime (66%). Escherichia coli isolates were most susceptible to meropenem (100%), imipenem (100%), amikacin (97.5%), nitrofurantoin (95%), ciprofloxacin (85.5%), norfloxacin (85%), chloramphenicol (83.5%), gentamycin (80%) and nalidixic acid (79%). Multidrug resistance (MDR) was observed in most (96.5%) E. coli isolates. Plasmid analysis revealed the presence of plasmid(s) in 165 (82.5%) of the E. coli isolates many of which had a plasmid size of 23 kb.

Conclusions: The overall incidence of antibiotic resistance (including MDR) among E. coli in this study was high to commonly used antibiotics, but no drug resistance to meropenem and imipenem was observed. Periodic monitoring of the drug resistance pattern is essential for better management of urinary tract infections, which has direct impact on the outcome of the patient.

Keywords: Escherichia coli; UTI; drug resistance; plasmid profile; urinary tract infections; uropathogenic.