Multidrug Drug Resistance of <i>Escherichia coli</i> and <i>Klebsiella</i> Isolated from Iraqi Patients and Microbiota

Abstract

Introduction: Escherichia coli and Klebsiella are Gram-negative bacilli of Enterobacteriaceae and are components of the colonic microbiota of animals and humans. The virulent strains cause gastroenteritis and urinary tract infections (UTI), and the incidence of the infections increases due to the increase of multidrug-resistant strains. The aim of this study is to determine the antibiotics resistance profile of E. coli and Klebsiella. Methodology: A total of 100 isolates of E. coli and Klebsiella were isolated from three sources, healthy stools and patient stools with gastroenteritis and urine subjects with UTI, during the period from November 2021 to January 2022. An antimicrobial susceptibility test was conducted with 14 antibiotics using the disc-Kirby-Bauer’s diffusion method. Results: Both E. coli and Klebsiella had variable abilities to resist the studied antimicrobial drugs, including 14 antibiotics belonging to nine different classes that have different patterns or mechanisms in stopping the growth or killing of microorganisms. All bacterial isolates revealed highly significant antimicrobial resistance almost for all antibiotics except carbapenems. About 72% of total isolates were multidrug-resistant (MDR), because they appeared resistant to at least three classes of antibiotics. Only two E. coli isolates out of 24 isolates (8.3%) were recovered from healthy stool samples and 6.25% of E. coli isolates (2 isolates out of 32) which were obtained from urine samples were sensitive to all antibiotics. The highest rates of antibiotic resistance were observed in E. coli than in Klebsiella. Both species had resistance to Amoxicillin-clavulanate (70.58%), Cefotaxime (58.96%), and Ceftazidime (57.81%). While the lowest frequency was meropenem (4.86%), and all strains were sensitive to imipenem (100%). Conclusion: These results partly explain the high prevalence of antibiotic resistance observed in Iraq due to drug misuse. Most of the bacterial strains were multidrug-resistant, and they spread more in pathogenic strains than in commensal strains.