ANTIBIOTIC RESISTANCE PATTERN OF ESCHERICHIA COLI ISOLATED FROM URINE SAMPLES AT MUFTI MEHMOOD HOSPITAL, DERA ISMAIL KHAN, KHYBER PAKHTUNKHWA, PAKISTAN

Abstract

Background: Urinary tract infections (UTIs) are among the most common bacterial infections, and Escherichia coli is their leading cause. Rising antibiotic resistance in uropathogenic E. coli limits empirical treatment options, and local resistance data are needed to guide therapy. Objective: To determine the antibiotic resistance pattern of E. coli isolated from urine samples and the prevalence of multidrug-resistant (MDR), extensively drug-resistant (XDR) and pan-drug-resistant (PDR) isolates at Mufti Mehmood Hospital, Dera Ismail Khan. Methods: In this laboratory-based cross-sectional study, 105 mid-stream urine samples from patients with recurrent UTI were cultured on Cystine Lactose Electrolyte Deficient (CLED) agar, and E. coli was identified by colony morphology, Gram staining and biochemical tests. Antibiotic susceptibility to 13 antibiotics was tested by the Kirby-Bauer disk diffusion method on Mueller-Hinton agar following CLSI guidelines. Isolates were classified as MDR, XDR or PDR. Results: Resistance was highest to ampicillin (97%), ceftriaxone (88%), cefazolin (85%), doxycycline (82%), co-trimoxazole (76%) and ciprofloxacin/levofloxacin (69%), followed by piperacillin-tazobactam (43%) and gentamicin (29%). Resistance was lowest to cefepime (0%), nitrofurantoin (14%), fosfomycin (16%), and imipenem and amikacin (24% each). Overall, 90% of isolates were MDR, 10% were XDR and none were PDR. Conclusion: E. coli isolates from UTI patients in Dera Ismail Khan show very high resistance to commonly prescribed oral antibiotics and a high burden of MDR. Nitrofurantoin, fosfomycin, amikacin and imipenem retained the best activity. Local antibiograms and strict antibiotic stewardship are urgently needed.

Keywords: Escherichia coli; antibiotic resistance; multidrug resistance; extensively drug resistance; urinary tract infection; Dera Ismail Khan