Multidrug-Resistant Escherichia coli and Klebsiella pneumoniae Isolated From Patients in Kashan, Iran

Abstract

Background:Escherichia coli and Klebsiella pneumoniae are common human pathogens that cause a wide spectrum of infections. Antimicrobial resistance is a basic obstacle in the management of these infections which has different patterns in various regions.Objectives:In this study, the antibiotic resistance patterns and risk factors for multidrug-resistant (MDR) E. coli and K. pneumoniae were determined.Patients and Methods:In this cross-sectional study, a total of 250 isolates (134 E. coli and 116 K. pneumoniae) were collected and antimicrobial resistances to ampicillin, amoxicillin-clavulanic acid, amikacin, gentamycin, ceftriaxone, ceftazidime, ciprofloxacin and imipenem were evaluated by disc diffusion method and confirmed by E-test. Moreover, risk factors for MDR E. coli and K. pneumoniae were also detected.Results:The mean ages of the culture-positive cases of E. coli and K. pneumoniae were 33.39 ± 24.42 and 36.54 ± 24.66 years, respectively (P = 0.31); 137 (54.8%) cases were male and 113 (45.2%) were female (P = 0.53). Nineteen (14.2%) isolates of E. coli and 12 (10.3%) isolates of K. pneumoniae were sensitive to all the evaluated antibiotics. The prevalence of MDR E. coli and MDR K. pneumoniae was 50% and 46.6%, respectively (P = 0.59). The highest resistance for both strains was to ampicillin and no imipenem resistance was seen. The risk factors for MDR E. coli were admission history during the recent three months (P = 0.043) and antibiotic use in the previous month (P = 0.03); for MDR K. pneumoniae, they were admission in the pediatric ward (P = 0.016), surgical ward (P = 0.019), or gynecology ward (P = 0.12), admission duration of > seven days, and antibiotic use during the past month (P = 0.04).Conclusions:The prevalence of multidrug resistance was high compared with developed countries, and history of admission, antibiotic use, admission duration and admission wards were the risk factors for multidrug resistance.

Antimicrobial Resistance Profiles for Different Isolates in Aden, Yemen: A Cross-Sectional Study in a Resource-Poor Setting

“…showed the highest resistance rate, 41.66%. A [34] and approximately 28.5% in community-acquired UTI [35]. Another study conducted in India revealed that the resistance rate of Klebsiella pneumoniae to ciprofloxacin was 80% [36].…”

Prevalence of CTX-M and TEM β-lactamases in Klebsiella pneumoniae Isolates from Patients with Urinary Tract Infection, Al-Zahra Hospital, Isfahan, Iran

“…Klebsiella pneumoniae is one of the most important human bacterial pathogens, result to the extensive range of community and hospital acquired infections that may lead to morbidity and mortality, particularly in immunocompromised patients. [ 1 2 ] Urinary tract infections (UTIs)-induced by multidrug-resistant (MDR) K. pneumoniae isolates are a serious public health problem. The potency of many antimicrobial agents have been limited, also these bacteria are hard and expensive to cure.…”

“…These divergences require geographical surveys due to their resistance patterns and risk factors. [ 2 ]…”

The growth influence of Escherichia coli co-cultured with other selected gram negative bacteria

“…In lactose media, Salmonella consumes metabolic waste from E. coli creating a mechanism of reciprocation for cooperation (Harcombe 2010). The interactions between E. coli and S. typhi may lead to infections, which may also lead to transfer of resistance to antimicrobial drugs (Moini et al 2015). The opportunistic pathogens use hierarchical quorum-sensing network to regulate virulence factor production that cooperatively benefit the population at a cost to the individual (Ron et al 2018).…”