Increased multi-drug resistant <i>Escherichia coli</i> from hospitals in Khartoum state, Sudan

Abstract

Background: Multidrug-resistant Escherichia coli (MDR E. coli) has become a major public health concern in Sudan and many countries, causing failure in treatment with consequent huge health burden. Objectives: To determine the prevalence and susceptibility of MDR E. coli isolated from patients in hospitals at Khartoum State. Methods: Between May to August 2011, E. coli (n = 232) isolated from clinical specimens, identified, tested their antimicrobials susceptibility and screened for extend spectrum â-lactamase production as per standard methods. Results: Of the 232 E. coli isolates, the majority were from urine (65.1%). MDR E. coli were present in 214 (92.2%). Of these, the resistance rates were recorded to: amoxicillin 97.7%, cefuroxime 92.5%, trimethoprim-sulfamethoxazole 88.3%, tetracycline 77.1%, nalidixic acid 72%, ceftriaxone 64%, ciprofloxacin 58.4%, ofloxacin 55.1%, amoxicillin-clavulanate 50.4%, ceftazidime, gentamicin 35% each, nitrofurantoin 22.4%, chloramphenicol, tobramicin 18.2% each and amikacin 1.9%. Overall MDR E. coli, 53.3% were resistant to > 7 antimicrobial agents and ESBL was detected in 32.7%. Isolates from males were more resistant than those from females (p < 0.05). Conclusions: Drug-resistance surveillance and epidemiological analysis of patient data is need periodically and can be informative for appropriate management of antimicrobial resistance.

Prevalence and molecular characterization of extended-spectrum b-Lactamases (blaTEM) producing Escherichia coli isolated from humans and foods of animal origin in Chhattisgarh, India

“…The highest numbers of E. coli isolates were found resistant to Erythromycin, Ampicillin and Cefotaxim (41.34%), followed by Ceftazidime (40.38%), Cephalexin, Cifixime, Ciprofloxacin, Meropenem (39.42%), Oxytetracyclin (37.50%), Amoxyclav (33.65%) with minimum resistant to Imipenem (2.88%) ( Table 2). Results of present study are in agreement with earlier findings (Ibrahim et al, 2012, Manoharan et al, 2011. Imipenem is an antibiotic which is recently introduced and possibly resistance against it is not developed among E. coli isolates.…”

Antimicrobial resistance in extended spectrum -lactamases (ESBL)-producing Escherichia coli isolated from human urinary tract infections in Ndjamena, Chad

“…Trimethoprim-sulfamethoxazole resistance was among the highest in our study (95%). Similar rates have been reported in several studies: 91% in Nigeria, 88.3% in Soudan (Ibrahim et al, 2012) 81% in Pakistan (Ullah et al, 2009) and 82% in India (Supriya et al, 2004). In France, resistance to trimethoprim-sulfamethoxazole in E. coli varies from 50 to 80% (Goldstein, 2006).…”

“…In Soudan, these rates were 72% to nalidixic acid and 58.4% to ciprofloxacin (Ibrahim et al, 2012). The rate of resistance to ciprofloxacin can be compared to the data obtained in Israel, Spain, London and Nigeria which were 72.05, 77, 91.3 and 80.9%, respectively (Aruna Ndoutamia et al 779 and Mobashshera, 2012;Iroha et al, 2009;Melzer and Petersen, 2012;Tamayo et al, 2007).…”

“…The combination of trimethoprime/sulfametoxazole is extensively used in Chad owing to its antimicrobial spectrum of activity and its low cost (Goldstein, 2006). In addition, ESBL-production is usually associated with resistance to non β-lactam antibiotic such as aminoglycosides, fluroquinolones and trimethoprim/sulfamethoxazole (Ibrahim et al, 2012). It is most likely that the selective pressure generated by overuse could explain the relatively high prevalence of resistance in E. coli.…”

Multidrug resistant Escherichia coli strains isolated from urine sample, University of Gondar Hospital, Northwest Ethiopia

“…Gram negative bacteria, especially Escherichia coli (E. coli) is the most prevailing cause of both community and hospital acquired UTIs. UTIs caused by MDR E. coli isolates are a major public health issue, since the efficacy of many antimicrobial agents has been compromised, thus reducing the therapeutic options significantly and making the provision of an appropriate antimicrobial therapy more challenging [4,5].…”