Multidrug-resistant E. coli in paediatric UTIs in a chilean hospital
Keywords:
E. coli, resistance, antibiotics, geneAbstract
The purpose of this study was to isolate and molecularly characterize antibiotic-resistant Escherichia coli from urine samples of children patients at the Pontifical Catholic University of Chile Clinical Hospital, Chile. The study sought to determine antibiogram profiling and resistance genes in multiple antibiotic-resistant bacterial isolates. A total of 300 urine samples were collected from children patients aged between 3-5 years, with 158 females and 142 males. The samples were transported on ice to the laboratory and analysed bacteriologically. The isolation of E. coli and other Gram-negative bacteria was carried out by streaking on Eosin Methylene Blue agar and incubated at 37ºC for 24 hours. Identification of isolates was preliminary through colony and morphological characteristics. Further identification was carried out by biochemical tests using Bergey’s manual of determinative bacteriology and Analytical Profile Index (API) Kits. Antibiotic susceptibility of isolates was determined using Kirby Bauer’s disc diffusion technique. Detection of resistance genes was carried out by Polymerase Chain Reaction (PCR) using appropriate primers. The study found that 40 (13.3%) E. coli were recovered from the 300 samples collected, with varying resistance to antibiotics. The highest resistance was observed for Augmentin (35, 87.5%), followed by Ceftriaxone (32, 80%), Gentamycin (30, 75%), Ofloxacin (28, 70%), Cefuroxime (26, 65%), Amoxicillin (16, 40%), Cefixime (11, 27.5%), Cotrimoxazole (10, 25%), Ciprofloxacin (9, 22.5%), Streptomycin (9, 22.5%), Pefloxacin (8, 20%), and Ceftazidime (4, 10%). All the E. coli isolates were found to be susceptible to Nitrofurantoin, Erythromycin, and Chloramphenicol. The isolates showed multiple resistance against 3 to 4 different classes of antibiotics, and the study recorded 12 multiple antibiotic resistance patterns. Eight of the twelve selected E. coli isolates had blaCTX-M gene, while five harboured the aac3-IV gene. The study concluded that the occurrence of E. coli infection is high in the study area, and there is a high level of multiple antibiotic resistance. The recovery of resistance genes (blaCTX-M and aac3-IV) in E. coli in the study is of great economic and health consequences. Therefore, antibiotics should only be used when prescribed by physicians to mitigate the problem of multiple antibiotic resistance
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