Determination of the carbapenem resistance in Escherichia coli isolated from samples obtained from Shahrekord hospitals and determination of their minimum inhibitory concentration

Abstract

Background and aims: Carbapenems are the final-line treatments for multidrug-resistant, gram-negative infections. The patterns of resistance to carbapenems among hospital bacterial pathogens vary widely across different hospitals in a country. Considering that Escherichia coli is one of the most important causes of nosocomial infections, it is essential to study its drug resistance. Methods: In this descriptive-analytical study, a total of 80 samples of E. coli isolated from inpatients with urinary tract infections (UTIs) were collected in different wards (i.e., women, urology, infectious, and ICU) of Shahrekord hospitals. After the diagnosis and confirmation of bacteria by standard bacteriological methods, their sensitivity to imipenem and meropenem was investigated by the antibiogram (diskdiffusion) method. Then, the minimum inhibitory concentration (MIC) was determined by the E-test strip according to the Clinical and Laboratory Standards Institute (CLSI) standard. Results: In this study, resistance to meropenem and imipenem by antibiogram (disc diffusion) was observed in 21 (25.26%) and 20 (25%) of the isolates, respectively. Twenty isolates had MIC ≥4 μg/mL for meropenem, 13 isolates demonstrated MIC≥4 μg/mL for imipenem, and 14 isolates had 1≤MIC<4 μg/mL and were semi-sensitive. Conclusion: In general, E. coli had significant resistance to carbapenems. Therefore, rapid and accurate identification of these strains can be a major step to the treatment and control of these strains and prevention of the spread of the resistance.

The occurrence of antibiotic resistance, ESBLs, MBL and NDM-1 in Uropathogenic Escherichia coli in Central part of Iran

“…The infections owing to E. coli are treated with broad-spectrum antibiotics [22][23][24]. Antibiotic resistance in these bacteria is increasing and is spreading all over the world [2]. Carbapenem and βlactam antibiotics are drugs of choice for E. coli infections.…”

“…The most common bacterial cause for UTI is Escherichia coli. UTIs report about 150 million cases each year and are more common in women than men [1][2][3]. Up to 10% of women have a UTI in a given year, and half of them have at minimum one infection at some point in their lifetime [4].…”

“…Class D β-lactamases or oxacillinases (OXA) are commonly distributed between clinically relate Gram-negative bacteria [7,8]. Carbapenem antibiotics are now used to treat infections caused by β-lactam resistant bacteria [2,9]. This antibiotic is used to treat infections caused by penicillin or cephalosporinresistant Gram-negative bacilli because this antibiotic, in addition to a broad spectrum of action, has acceptable stability against most β-lactamase [2,10,11].…”

“…Carbapenem antibiotics are now used to treat infections caused by β-lactam resistant bacteria [2,9]. This antibiotic is used to treat infections caused by penicillin or cephalosporinresistant Gram-negative bacilli because this antibiotic, in addition to a broad spectrum of action, has acceptable stability against most β-lactamase [2,10,11]. Resistance to carbapenem is mainly created with Metallo-β-lactamases (MBL) such as NDM (New Delhi Metallo-β-lactamase), a class B type of βlactamases that know bivalent metal ions [12,13].…”