One year surveillance of antimicrobial sensitivity pattern of different antibiotics on clinical isolates of Escherichia coli with comparison of resistance against different antibiotics in four major cities in Bangladesh

Shamema Nasrin, Fatema Tuz Zohera, Sheikh Arman Mahbub, Halima Akther, Mahamudul Haque

Abstract


Background: The aim of study was to provide supportive implications for proper treatment of E. coli induced infections and related complications regarding antibiotic resistance.

Methods: Total 600 isolates of E. coli from four major cities of Bangladesh were included in studies which were isolated from clinical diagnostic facilities in Dhaka, Chittagong, Rajshahi and Khulna. The antimicrobial sensitivity test of each E. coli isolate to 16 antimicrobial agents was carried out by the Kirby-Bauser disc diffusion method.

Results: In the present investigation, the most effective antimicrobial against E. coli was found to be antibiotics of Carbapenem group; Doripenem 98.67% sensitive in Dhaka and Chittagong, 100% sensitive at Rajshahi and Khulna, Meropenem 89.33, 92.67, 95.33 and 97.33%, Imipenem 84.00, 86.00, 95.33 and 97.33 in Dhaka, Chittagong, Rajshahi and Khulna respectively. Apart from these third generation antibiotics like Cefixime 80.00% (D), 78.67% (C),78.00% (R), 82.00% (K) and Ceftriaxone 78.00% (D), 76.67(C), 65.33(R), 66.67(K) were shown satisfactory amount of sensitivity against E. Coli. Our research reveals that in Bangladesh commonly used conventional older, common, cheaper antibiotics used against E. coli were shown alarming rate of resistance to E. coli strains. Among them Amoxicillin, Tetracycline, Cloxacillin and Nalidixic Acid showed more than 80% resistance in most of the areas. Most widely used antibiotic Ciprofloxacin has become 39.99 to 49.99% resistant.

Conclusion: These findings suggest urgent need for creating greater public awareness about antibiotic. It is also important that healthcare providers effectively communicate with their patients, to improve treatment compliance and health outcomes.


Keywords


Antibiotic Susceptibility, Resistance, E coli

Full Text:

PDF

References


Walash JA, Warren KS. Selective primary health care; an interim strategy for disease control in developing countries. New Engl J Med 1979;301:967-74.

Kunin CM. Rational use of antibiotics. WHO Drug information. 1990;4(1):4-7.

Hart & Kariuki. Antimicrobial resistance in developing countries. Br Med J 1998; 317: 647-50.

Shears P. Antibiotic resistance in the tropics. Trans. Roy. Soc. Trop. Med and Hyg 200 l;95:127-130.

Eyassu Habte-Gabr. Antimicrobial Resistance: A Global Public Health Threat. Journal of Eritrean medical association 2010;1:36-40.

Aseffa A, Yohannes G. Antibiotic sensitivity patterns of prevalent bacterial pathogens in Gondar, Ethiopia. East Afr Med J. 1996;73(1):67-71.

M. Cheesbrough, Medical Laboratory Manual for Tropical Countries, Microbiology, Vol 2 Tropical Health Technology/Butterworth and Co. Ltd., Cambridgeshire/Kent;1984.

Bauer AW, Kirby WM, Sherris JC, Turck M. Antibiotic susceptibility testing by a standardized single disk method. Am J Clin Pathol. 1966 Apr;45(4):493-6.

National Committee for Clinical Laboratory Standards, Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically, 3rd Edition, approved standard (NCCLS, Pennsylvania, Document M7-A3, 1997.

Coyle MB. Manual of Antimicrobial Susceptibility Testing. American Society for Microbiology Press, Washington D.C. 2005; 25-39.

Cheesbrough M. District Laboratory Practice in Tropical Countries. Cambridge University press. 2006;434.

Iqbal MK, Patel IK. Susceptibility patterns of Escherichia coli: Prevalence of multidrug-resistant isolates and extended spectrum beta-Lactamase phenotype. J Pak Med Asso. 2002; 52:407-17.

Hossain MM, Glass RI, Khan MR. Antibiotic use in a rural community in Bangladesh. Int J Epidemiol 1982;11:402-5.

Goel P, Ross-Degnan D, Berman P, Soumerai S. Retail pharmacies in developing countries: a behavior and intervention framework. Soc Sci Med 1996;42:1155-61.

Winokur, P.L., D.L. Vonstein, L.J. Hoffman, E.K. Uhlenhopp and G.V. Doern. Evidence for transfer of CMY-2 AmpC beta-lactamase plasmids between Escherichia coli and Salmonella isolates from food animals and humans. Antimicrob. Agents Chemother 2001;45:2716-22.

Rosas I, Salinas E, Yela A, Calva E, Eslava C, Cravioto A. Escherichia coli in settled-dust and air samples collected in residential environments in Mexico City. Appl Environ Microbiology 1997; 63:4093-5.

McDonald, L. C., Chen, F. J., Lo, H. J., Yin, H. C., Lu, P. L., Huang, C. H., Chen, P., Lauderdale, T. L. & Ho, M. Emergence of reduced susceptibility and resistance to fluoroquinolones in Escherichia coli in Taiwan and contributions of distinct selective pressures. Antimicrobial Agents Chemotherapy 2001; 45:3084-91.

Ena, J., Lopez-Perezagua, M.D., Martinez-Peinado, C., Cia-Barrio, A.D., Ruiz-Lopez, I. Emergence of ciprofloxacin resistance in Escherichia coli isolates after widespread use of fluoroquinolones. Diagn. Micr. Infec. Dis. 1998; 30:103-7.

Calva JJ, Ceron E, Bojalil R. Holbrook A. Antibiotic consumption in a community of Mexico City. II. Survey of purchases at pharmacies. Bol. Med. Hosp. Infant. Mex 1993; 50:145-150.

Dua V, Kunin CM, White LV. The use of antimicrobial drugs in Nagpur, India. A window on medical care in a developing country. Soc Sci Med 1994; 38:717-24.

Haak H. Pharmaceuticals in two Brazilian villages: lay practices and perceptions. Soc Sci Med 1988;27:1415-27.

Lau SM, Peng MY, Chang FY. Resistance rates to commonly used antimicrobials among pathogens of both bacteremic and nonbacteremic community-acquired urinary tract infection. Microbiol Immunol Infect 2004;37(3):185-191.

Lansang MA, Lucas-Aquino R, Tupasi TE, Mina VS, Salazar LS, Joban N. Purchase of antibiotics without prescription in Manila, the Philippines. Inappropriate choices and doses. J Clin Epidemiol. 1990;43:61-7.