Antibiotic Resistance Status of E.coli Isolated from Intensive Care Units of Adjara Hospitals

Abstract

Abstract Background: Nosocomial infections are the group of infections that pose the greatest threat in terms of their cause- microorganisms, developing and spreading resistance to antibiotics (Keskin Seremet, et al., 2020). In addition, prolonged hospital stays, violation of sterilization and disinfection regulations in some cases, lack of professionalism, and shortage of knowledge among medical workers (Butsashvili et al., 2010) contribute to the spreading of these infections and the development of antibiotic resistance. coli is the leading infection in the urinary tract. This bacterium is the one that predominates in both nosocomial and community-acquired urinary tract infections (Alaniz et al., 2018) (Plate et al., 2019). Objective: To identify E. coli in samples with suspected nosocomial infection, isolate pure culture, and determine antibiotic resistance in various biological fluids. Materials and Methods: The study covered the following biological material obtained from the patients who spent 48 hours or more in the intensive care unit (total of 540): sputum, urine, material from the surface of the tip of venous and urinary catheters. Various biological samples underwent a retrospective study. The bacteria were isolated and identified with the standard bacteriological methods, namely by sampling from the appropriate nutrient zones and then by separating the pure culture. Finally, cultures were identified using the API test, and sensitivity to antibiotics was determined by Kirby-Bauer diffusion and E-test. The double-disk method was applied to determine the producers of E. coli broad spectrum beta-lactamase (ESBL). Result: The total of 540 samples was analyzed, out of which 236 were rejected as defective and 82 were gram-positive bacteria, and only 45 E. coli isolates were obtained from the remaining 158 samples. Thereof, 26 were resistant, and 23 were susceptible to antibiotics. Out of 158 samples, 89 were taken from sputum, –47 from urine, biological fluids-exudates from the tip of venous and urinary catheters. The highest degree of E. coli was found in sputum (56%) and urine (29%). The analysis for antibiotic sensitivity in samples showed that the resistance rate of E. coli isolated in the intensive care units in Adjara was quite high. All isolates were 100% resistant to antibiotics such as CXM/Cefuroxime, CRO/Ceftriaxone, CAZ/Ceftazidime, CTX/Cefotaxime, and AMP/Ampicillin. The resistance rate of 70-80% to FEP/Cefepim, CIP/Ciprofloxacin, LVX/Levofloxacin, ATM/Aztreonam, AMC/Amoxicillin/clavulanic acid, and DOX/Doxycycline was recorded in E. coli isolates. Conclusion: Only 3 antibiotics can be effective against Escherichia coli such as CST/Colistin, IPM/Imipenem, and MEM/Meropenem.