Association between antimicrobial consumption and resistance rate ofEscherichia coliin hospital settings

Abstract

Aims This study aims to quantify antimicrobial consumption (AMC) and antimicrobial resistance (AMR) in tertiary care hospitals in Pakistan. Methods and results This observational study was conducted at two tertiary care hospitals of Pakistan over a 1-year period. The AMC and resistance patterns of Escherichia coli isolates collected from hospitals were observed and analysed using the pearson correlation coefficient. AMC in hospitals varied between 0.00186 and 0.72 (Mean = 0.12 ± 0.191) Defined Daily Dose (DDDs)/1000 patient-days. Fluoroquinolones were the most consumed antimicrobial followed by penicillins, cephalosporins, carbapenems, and aminoglycosides. Antimicrobial-resistant rates in hospitals varied between 92.2% and 34.6%. The highest resistance rate was observed for moxifloxacin, followed by ampicillin, cefotaxime, amoxicillin, ceftriaxone, ciprofloxacin, amoxiclav, and amikacin. Statistically significant association was found between AMC and resistance rate for ampicillin (r = 0.78, P = 0.032), cefotaxime (r = 0.87, P = 0.012), ceftriaxone (r = 0.67, P = 0.042), and ciprofloxacin (r = 0.63, P = 0.031). Additionally, there was a significant association between fluoroquinolone consumption and the resistance rate of third generation cephalosporins (r = 0.61, P = 0.032), and significance was also found when all antimicrobials were combined into 1 analysis (r = 0.721, P = 0.032). Conclusion This data documented a significant association between AMC and resistant rates for multiple antimicrobial agents.

Whole genome-based genetic insights of bla NDM producing clinical E. coli isolates in hospital settings of Pakistant

“…The emergence of MDR E. coli isolates is causing therapeutic failures that are a serious public health threat and lead to high morbidities and mortalities in hospital settings ( 43 ). This study reported a high resistance rate for fluoroquinolones (95–100%), cephalosporins (88–95%), penicillins (82–97%), and aminoglycosides (58%).…”

Multiple-Drug Resistant Shiga Toxin-Producing E. coli in Raw Milk of Dairy Bovine

“…Extreme use of antibiotics for livestock management practices and conducive horizontal gene transfer systems within the E. coli family could be linked to the recorded high resistance. This poses a greater threat of zoonotic disease outbreaks in these countries [ 32 ].…”

Antibiotic Overprescribing among Neonates and Children Hospitalized with COVID-19 in Pakistan and the Implications

“…These high rates need to be urgently addressed, given the already rising rates of AMR in Pakistan, and ongoing challenges to reduce this as part of their national action plan to reduce AMR [ 78 , 79 ]. We are seeing antimicrobial stewardship programs (ASPs) being successfully introduced among hospitals across LMICs to improve appropriate antibiotic prescribing despite initial concerns, and these can serve as exemplars for Pakistan in the future [ 44 , 45 , 80 , 81 , 82 , 83 ]. We will be following this up in future studies now that the AWaRe book has been published, providing guidance for a range of infections, combined with suggested prescribing and quality indicators [ 60 , 84 ].…”

“…Excessive prescribing of antibiotics is a concern, as their inappropriate and unjustified use increases antimicrobial resistance (AMR) [ 40 , 41 , 42 , 43 , 44 , 45 ]. Increasing AMR appreciably increases morbidity, mortality and costs, and has been described as the next pandemic unless addressed [ 42 , 46 , 47 , 48 , 49 ].…”