Abstract
Antimicrobials have been playing an important role in preventing illness and death associated with infections due to bacteria. However, the emergence and spread of resistance by pathogens have decreased the effectiveness of the commonly prescribed antimicrobials. Intestinal Escherichia coli are among bacterial pathogens that are endowed with such resistance traits because they are important source and reservoir of genes that encode antimicrobial resistance. To determine the antimicrobial resistance profile of fecal isolates of E. coli from diarrheic patients. Stool samples were collected consecutively from 100 individuals who visited Selam Health Center during the study period, April to June 2018. Samples were collected and transported under sterile condition to the National Clinical Bacteriology and Mycology reference Laboratory, Ethiopian Public Health Institute. The samples were streaked on MacConkey agar and incubated overnight at 37°C. E. coli isolates were further confirmed using conventional biochemical tests. Antimicrobial susceptibility status was determined using the disk diffusion method on Mueller Hinton agar as recommended by the Clinical Laboratory Standard Institute. The raw data was compiled and entered to spreadsheet and analysis was done using SPSS Version 20 with p-value ≤0.05 considered statistically significant. Out of the 100 patients, 43 were female and the rest were male. Confirmed E. coli were isolated from 73 individuals. Antimicrobial susceptibility testing showed that E. coli isolated in this study were highly resistant to trimethoprim-sulfamethoxazole 49 (67.1%) and amoxicillin-clavulanic acid 47(64.4 %). No isolates showed resistance to gentamicin and tobramicin. Of all the isolates, 11(15.1%) were multidrug resistant. No association was observed between antimicrobial resistance status and sex of individuals included in this study. However, there was an association between age and resistance patterns. Resistance to commonly prescribed antibiotics among E. coli isolated in this study was high and a considerable proportions of the strains were multidrug resistant. This is an indication for an alarming rate of resistance of intestinal E. coli to first line antimicrobials. To reduce the problem, regular monitoring and education for the community are very important. Key words: Escherichia coli, antibiotic susceptibility, multidrug resistant, Ethiopia, biochemical tests, disk diffusion.
Highlights
Antimicrobials have been playing an important role in preventing illness and death associated with bacteria infections
Since the selection of colonies from the primary media for further analysis was random, 73 E. coli isolates from the collected stool samples could be obtained, of which 43 isolates were derived from female participants and 30 E. coli isolates were from male patients
There is no compiled Ethiopian study data on antibiotic prescription dosage, studies in other part of the world indicate that the greatest proportion of antibiotics for human use is prescribed at primary healthcare sector (Fernando et al, 2017), where use is strongly correlated to antibiotic resistance rates highlighting this sector as an important area for research and intervention (Bell et al, 2014)
Summary
Antimicrobials have been playing an important role in preventing illness and death associated with bacteria infections. The emergence and spread of resistant pathogenic and commensal bacteria is. Increasing all over the world (Aarestrup et al, 2008). Increased resistance to antibiotics has made it difficult to treat infections due to bacteria and even impossible in the extreme cases which in turn results in morbidity and mortality. The problem is serious in developing countries where the availability of alternative antimicrobials is very low and too expensive (Eliopoulos et al, 2003). The World Health Organization (WHO) has raised this issue as a global challenge and a major threat of healthcare in the society today (WHO, 2014)
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