Abstract
Background: The development of multi-antibiotic resistant bacteria, especially Gram-negative bacteria which are the major cause of hospital-acquired infections worldwide, had been increasing. Escherichia coli and Klebsiella sp. had become more resistant to different classes of antibiotics, and the treatment of infections caused by these bacteria had developed into a challenge in both developed and developing countries. This study had determined the multi-antibiotic resistance (MAR) patterns of Escherichia coli and Klebsiella sp. isolated from clinical inpatient and outpatient samples. Method: The present study had used 50 E. coli and 48 Klebsiella sp. isolates. Antibiotic susceptibility test had been carried out by using disk diffusion method, and the interpretation of results of the zones of inhibition had accorded with Clinical Laboratory Standards Institute (CLSI). The antibiotics used had included the following: streptomycin, ciprofloxacin, erythromycin, nitrofurantoin, amikacin, gentamicin, ofloxacin, cefepime, oxacillin, colistin sulfate, cefotaxime, ceftazidime, pefloxacine, and cloxacillin. Results: E. coli and K. pneumoniae had shown high-resistance patterns. E. coli had exhibited high resistance against cloxacillin (96%), oxacillin (96%), erythromycin (88%), and most especially streptomycin (98%). Similarly, K. pneumoniae had presented a high resistance to streptomycin (88%), cloxacillin (92%), oxacillin (92%), and colistin (92%). E. coli had presented the highest multidrug resistance with a MAR index of 1.00. A total of 17 E. coli isolates had shown resistance to the 14 antibiotics tested. Conclusion: E. coli and Klebsiella sp. in clinical isolates in outpatients and inpatients in Ibadan, Western Nigeria had demonstrated high antimicrobial resistance. Thus, such condition should be considered a major public health concern, and measures must be taken to establish the sources and drivers of this problem.
Highlights
Antibiotic resistance (AR) is a global problem especially in the developing countries; this condition increasingly compromises the outcome of various infections that were until recently, treatable and remain the common infections in Africa.[1]
The percentile distribution was obtained for the prevalence of resistance of isolates to different classes of antibiotics, including penicillin, aminoglycosides, fluoroquinolones, macrolides, nitrofurantoin, extended spectrum cephalosporins, and colistin sulfate (Figures 3 and 4)
Comparison focused on the resistance patterns between E. coli and Klebsiella (Figure 5)
Summary
Antibiotic resistance (AR) is a global problem especially in the developing countries; this condition increasingly compromises the outcome of various infections that were until recently, treatable and remain the common infections in Africa.[1]. The infections caused by antibiotic resistant bacteria, most especially multi-resistance bacteria, can lead to serious health problems, such as long hospital stay, treatment failure, and death.[3] The major factors causing the development of bacterial resistance include the indiscriminate use of antimicrobial agents in human and animal medicine, agriculture, and aquatic farming. Different mechanisms or their combination are used by bacteria in developing resistance to antibiotics; a particular mechanism may be dominant and can be identifiable.[4] The presence of plasmids that contain one or more resistance genes, with each encoding a single AR phenotype, often causes the development of multiple AR (MAR) in bacteria.[5] These AR genes can transfer to other bacteria of the same or different species. Conclusion: E. coli and Klebsiella sp. in clinical isolates in outpatients and inpatients in Ibadan, Western Nigeria had demonstrated high antimicrobial resistance
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