Dynamics of antimicrobial resistance of uropathogenic isolates of Escherichia coli

Abstract

Objective. To evaluate the dynamics of antimicrobial resistance of Escherichia coli isolates from the urine of patients hospitalized in medical institutions of Tashkent city from 2018 to 2021. Materials and Methods. The study included 1020 E. coli isolates from the urine of patients with clinical symptoms of urinary tract infections admitted to the reference laboratory of the Antimicrobial Resistance Research Center (ARRC) from three medical institutions in Tashkent city for the period 2018– 2021. Determination of sensitivity to 15 antimicrobial agents was carried out by disc-diffusion method in accordance with the guidelines of the European Committee for the Determination of Sensitivity to Antimicrobial Agents (EUCAST v.8-v.12, depending on the year of isolates isolation and testing). Results. A high level of resistance to aminopenicillins, including inhibitor-protected ones (88.0–91.1%), 3–4 generation cephalosporins (84.5–87.7%) and fluoroquinolones (74.2–81.8%) was detected. Carbapenems showed the highest activity among the tested antimicrobials: resistance to imipenem, meropenem and ertapenem was 0%, 0.8% and 18%, respectively. Notable increase in resistance to ampicillin and ceftazidime was found, but a consistently high level of resistance to piperacillin-tazobactam. A statistically significant increase (p < 0.001) was found between 2018–2021 in resistance to the aminoglycoside antibiotics amikacin and gentamicin from 3.2% and 37.8% to 85.4% and 80.6%, respectively. Conclusions. In our study, for most antibiotic groups, the level of resistance remained relatively stable from 2018 to 2021, except for an explosive increase in the frequency of resistance to aminoglycosides, as well as a further increase in resistance to ampicillin and ceftazidime. The need for monitoring and tracking of antibiotic pathogens when choosing treatment regimens for various infections is obvious.