Antibiotic-resistant pathogenic bacterial isolates from patients attending the outpatient department of university of Cape Coast hospital, Ghana: A retrospective study between 2013–2015

Abstract

Uropathogenic Escherichia coli (E. coli) is an important urinary tract infection (UTI) that has been associated with both complicated and uncomplicated disease conditions. The global emergence of multiple drug-resistant (MDR) and extended-spectrum β-lactamase (ESBL) is of public health concern as the resistance limits the current treatment options. The objective of this study was to analyze the antibiotic-resistant patterns among the uropathogenic E. coli isolates at the University of Cape Coast (UCC) hospital between 2013 and 2015 as baseline data to understand the current antibiotic resistance situation within UCC and its environs. A retrospective cross-sectional study of bacteria isolates at UCC hospital from January 2013 to December 2015 were analyzed. A standard biochemical and antibiotic susceptibility tests were performed using Kirby-Bauer NCCLs modified disc diffusion technique. The network of interaction between pathogenic isolates and antibiotic resistance was performed using Cytoscape software. Statistical significance was tested using ANOVA and one-sample Wilcoxon test. The overall E. coli prevalence was 15.76% (32/203); females had the highest infection of 17.33% (26/150) compared to male subjects who had 11.32% (6/53) out of all the pathogenic infections. The E. coli prevalence among the age categories were 2/21 (9.52%), 27/154 (17.53%) and 4/21 (19.05%) among ≤20 years, 21–40 years and 41–60 years respectively. The isolated resistant pathogens exhibited different antibiotic resistance patterns. An interaction network of nodes connecting to other nodes indicating positive correlations between the pathogens and antibiotic resistance was established. Escherichia coli, Citrobacter spp, Klebsiella spp among other isolated pathogens formed higher centrality in the network of interaction with antibiotic resistance. The individual E. coli isolates showed a significant difference in the mean ± SD (95% CI) pattern of antibiotic resistance, 2.409±1.205 (1.828–2.990), χ2 = 36.68, p<0.0001. In conclusion, the study reports the interaction of E. coli isolates at UCC hospital and its antibiotic-resistant status between 2013 and 2015. This data forms the baseline information for assessing the current antibiotic status in UCC and its environs.

Association of Virulence Markers With Resistance to Oral Antibiotics in Escherichia coli Isolates Causing Uncomplicated Community-Acquired Cystitis

“…The steady increase in antibiotic resistance is being reported in many UPEC strains [ 4 , 16 ]. β-lactams, trimethoprim-sulfamethoxazole (TMP/SMX), fluoroquinolones, and nitrofurantoin are the most common antibiotics used in the treatment of community-acquired UTIs [ 17 ].…”

“…Improper stewardship, inappropriate use of unprescribed antibiotics, and over-prescription of broad-spectrum antibiotics are among a few contributing factors to the rapid emergence of antibiotic resistance. The presence of MDR is interconnected with high rates of imperfect empirical antibiotic therapy, which ultimately leads to treatment failure in patients suffering from UTI [ 4 , 16 , 18 ]. Therefore, in recent years, the treatment of community-acquired UTIs is becoming a global concern due to the emergence of MDR E. coli [ 16 ].…”

“…The presence of MDR is interconnected with high rates of imperfect empirical antibiotic therapy, which ultimately leads to treatment failure in patients suffering from UTI [ 4 , 16 , 18 ]. Therefore, in recent years, the treatment of community-acquired UTIs is becoming a global concern due to the emergence of MDR E. coli [ 16 ].…”

“…VFs are essential for the bacteria to overcome the host defence system, colonize, and survive, while the acquisition of antibiotic resistance helps bacteria to overcome antimicrobial therapies and to adapt to colonize adverse environments [ 19 , 21 ]. Thus, establishing any correlation between virulence and antibiotic resistance can further help in studying targeted/alternative drug therapy [ 16 , 22 ]. This study was planned to determine the presence of virulence genes among E. coli isolates and their correlation with antimicrobials commonly used in the treatment associated with community-acquired UTI.…”

ANTIMICROBIAL ACTIVITY: DIFFERENT MECHANISTIC ELUCIDATION OF ANTIBACTERIAL, ANTIVIRAL, ANTIFUNGAL & ANTIALGAE AGENTS

“…In recent days, multidrug resistant pathogenic microorganisms have created a serious problem in medical sciences. 4 They cannot be destroyed by conventional antibiotics, and hence cause several diseases and infections to human health. 5 This phenomenon leads to an urgent requirement to prepare several alternative antimicrobial agents.…”