Abstract
Multi-drug-resistance (MDR) is a severe public health concern worldwide, and its containment is more challenging in developing countries due to poor antimicrobial resistance (AMR) surveillance and irrational use of antibiotics. The current study investigated 100 clinical E. coli isolates and revealed that 98% of them were MDR. PCR analysis using 25 selected isolates showed the predominance of metallo-β-lactamase gene blaNDM (80%) and ESBL genes blaOXA (48%) and blaCTX-M-15 (32%). The AmpC gene was detected in 68% of the isolates, while 32% was tetC positive. Notably, 34% of the isolates were resistant to carbapenem. Whole genome sequence (WGS) analysis of an extensively drug-resistant (XDR) isolate (L16) revealed the presence of the notorious sequence type 131 responsible for multi-drug-resistant infections, multiple antibiotic resistance genes (ARGs), virulence genes, and mobile genetic elements that pose risks to environmental transmission. Our results indicate that MDR is alarmingly increasing in Bangladesh that critically limits the treatment option against infections and contributes to further aggravation to the prevailing situation of MDR worldwide. The findings of this study will be valuable in designing sustainable strategies to contain MDR in the region.
Highlights
Bacterial resistance to antibiotics is a global health crisis with far-reaching consequences
E. coli is considered a good indicator of antibiotic resistance in bacterial communities as it has been known to be a significant reservoir of genes coding for antimicrobial drug resistance[14]
The current study has been conducted on 100 E. coli isolates obtained from clinical specimens collected from different diagnostic centers in Dhaka, Bangladesh
Summary
Bacterial resistance to antibiotics is a global health crisis with far-reaching consequences. E. coli is considered a good indicator of antibiotic resistance in bacterial communities as it has been known to be a significant reservoir of genes coding for antimicrobial drug resistance[14]. Several studies conducted in Bangladesh revealed the irrational use of antimicrobials, prevalence of self-treatment, and incomplete therapy that contributed to the emergence of resistant bacterial s trains[2,17,18]. Lack of systematic and detailed studies on antibiotic resistance patterns from Bangladesh often makes physicians prescribe multiple antibiotics, including broad-spectrum antibiotics, which further aggravates the AMR situation in Bangladesh, where infectious diseases still hold the highest morbidity and mortality r ate[18,19]. We determined the antibiotic resistance pattern in E. coli isolates from clinical urine and sputum specimens collected from pathological laboratories of Dhaka, Bangladesh. The concordance between WGS-based AMR prediction and the phenotype identified from conventional antimicrobial susceptibility tests was evaluated
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