Hospital Acquired Pathogenic Escherichia coli from Clinical and Hospital Water Samples of Quetta Balochistan

Abstract

A study was conducted to determine the prevalence and drug resistance of Escherichia coli present in urinary tract infected patients and hospital drinking water. A total of eighty urine samples from clinically suspected patients and thirty tap water samples from hospital vicinity were collected and analyzed for the presence of E. coli. The isolates were preliminary identified based on morphological characteristics, biochemical test and further confirmed by polymerase chain reaction (PCR) using uidA primer. Isolates were subjected to antibiogram studies and analyzed for the presence of drug resistance (ESBL blaCTX-M-15, tetA, and TMP-SMX dfrA1) and pathogenicity associated pyelonephritis-associated pili (PAP) and Heat-labile (LT) toxin genes. Urine samples 19/80 (23.75%) and water samples 8/30 (26.7%) were found contaminated with E. coli. It was found that 12/19 (63%) bacterial isolates were extended spectrum beta-lactamase (ESBL) producers in clinical and 6/8 (75%) in water isolates whereas tetracycline resistance in clinical and water isolates was 11/19 (58%) and 6/8 (75%), respectively. The trimethoprim resistance gene was confirmed in 12/19 (63%) in clinical and 2/8 (25%) in water isolates. All the clinical and water isolates were found carrying pili PAP gene. It was concluded that the presence of drug resistant and pathogenic E. coli in clinical and water samples is extremely alarming for public health due to cross contamination and bacterial transfer from clinical samples to water and vice versa.

Antimicrobial Resistance Patterns and Risk Factors Associated with ESBL-Producing and MDR Escherichia coli in Hospital and Environmental Settings in Lusaka, Zambia: Implications for One Health, Antimicrobial Stewardship and Surveillance Systems

“…The prevalence of E. coli found in our study is higher than that reported in Pakistan where 23.75% of E. coli were isolated from urine samples [100]. A study in Poland reported a higher E. coli isolation rate of 78% (identified using 16S rRNA sequencing) and 82% (identified using MALDI Biotype) from river water and wastewater [100]. However, our isolation rate of E. coli from water samples was lower compared to that reported in Pakistan where the researchers found an isolation rate of 26.7% [100].…”

“…Our low prevalence of E. coli isolated from the environment compared to the hospital setting could be due to the challenges in isolation methods of E. coli from environmental samples [ 99 ]. The prevalence of E. coli found in our study is higher than that reported in Pakistan where 23.75% of E. coli were isolated from urine samples [ 100 ]. A study in Poland reported a higher E. coli isolation rate of 78% (identified using 16S rRNA sequencing) and 82% (identified using MALDI Biotype) from river water and wastewater [ 100 ].…”

“…A study in Poland reported a higher E. coli isolation rate of 78% (identified using 16S rRNA sequencing) and 82% (identified using MALDI Biotype) from river water and wastewater [ 100 ]. However, our isolation rate of E. coli from water samples was lower compared to that reported in Pakistan where the researchers found an isolation rate of 26.7% [ 100 ]. These differences in isolation rates could be due to technical differences and slight variability in methods.…”