Dataset Information

Twelve-year trend of Escherichia coli antibiotic resistance in the Islamabad population

ABSTRACT:

Objective

Increasing rates of antimicrobial resistance among E. coli is a growing concern worldwide. We aimed to assess the changing antibiotic sensitivity pattern in Uropathogenic E. coli over a period of 12 years with special emphasis on ESBL-producing E. coli.

Methods

A retrospective study was done on the population of Islamabad from 1st Jan 2005 to Dec 2010 and then continued from 1st Jan 2016 to 31st May 2021. A total of 12000 samples were analyzed for isolation and identification of bacteria and antimicrobial susceptibility testing, from patients having uncomplicated urinary tract infections. Our primary was to find the antibiotics with the highest sensitivity against E. Coli in 2021, while our secondary outcome was to find the overall sensitivity pattern of E. Coli to antibiotics from 2005 to 2021.

Results

There was a decrease in susceptibility rates of E. coli to Amoxicillin-Clavulanic Acid 47%, Trimethoprim-Sulfamethoxazole (TMP-SMX) 27%, Fluoroquinolones 24% & Cephalosporins 38%. There was a significant increase in the use of Nitrofurantoin and Fosfomycin. High resistance rates to Fluoroquinolones (76%), TMP-SMX (73%), Cephalosporins (62%), and Amoxicillin (53%) were documented. However, significantly high degree of sensitivity rates to Fosfomycin (92%), Aminoglycosides (90%) & Nitrofurantoin (80%) were recorded.

Conclusions

Uropathogenic E. coli shows the highest sensitivity to Fosfomycin and Aminoglycosides in the year 2021, followed by Nitrofurantoin and Sulbactam. Cephalosporins, Amoxicillin/Cluvalanic acid, TMP-SMX, and Fluoroquinolones show a declining sensitivity pattern. UTIs can be prevented well by lifestyle changes, taking vitamins, trace elements, and carbohydrates. Highlights • This article is discussing the antibiotic sensitivity pattern in Uro-pathogenic E. coli over a period of 12 years having a special emphasis on ESBL-producing E. coli• Uropathogenic Ecoli have the highest sensitivity to Fosfomycin and Aminoglycosides in the year 2021, followed by nitrofurantoin and Sulbactam.• Dietary recommendations could be a first step toward prevention of UTI recurrence because eating habits appear to be a key risk factor.• UTIs can be prevented well by taking vitamins, trace elements, and/or carbohydrates. These antibacterial agents work well when combined. Antibiotic overuse and the prevalence of antibiotic-resistant microbes pose a serious danger to the use of probiotics.• Further monitoring of antimicrobial susceptibility is recommended in the upcoming years for effective treatment.

SUBMITTER: Bangash K

PROVIDER: S-EPMC9207067 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:Biofilms are considered to be highly resistant to antimicrobial agents. Several mechanisms have been proposed to explain this high resistance of biofilms, including restricted penetration of antimicrobial agents into biofilms, slow growth owing to nutrient limitation, expression of genes involved in the general stress response, and emergence of a biofilm-specific phenotype. However, since combinations of these factors are involved in most biofilm studies, it is still difficult to fully understand the mechanisms of biofilm resistance to antibiotics. In this study, the antibiotic susceptibility of Escherichia coli cells in biofilms was investigated with exclusion of the effects of the restricted penetration of antimicrobial agents into biofilms and the slow growth owing to nutrient limitation. Three different antibiotics, ampicillin (100 microg/ml), kanamycin (25 microg/ml), and ofloxacin (10 microg/ml), were applied directly to cells in the deeper layers of mature biofilms that developed in flow cells after removal of the surface layers of the biofilms. The results of the antibiotic treatment analyses revealed that ofloxacin and kanamycin were effective against biofilm cells, whereas ampicillin did not kill the cells, resulting in regrowth of the biofilm after the ampicillin treatment was discontinued. LIVE/DEAD staining revealed that a small fraction of resistant cells emerged in the deeper layers of the mature biofilms and that these cells were still alive even after 24 h of ampicillin treatment. Furthermore, to determine which genes in the biofilm cells are induced, allowing increased resistance to ampicillin, global gene expression was analyzed at different stages of biofilm formation, the attachment, colony formation, and maturation stages. The results showed that significant changes in gene expression occurred during biofilm formation, which were partly induced by rpoS expression. Based on the experimental data, it is likely that the observed resistance of biofilms can be attributed to formation of ampicillin-resistant subpopulations in the deeper layers of mature biofilms but not in young colony biofilms and that the production and resistance of the subpopulations were aided by biofilm-specific phenotypes, like slow growth and induction of rpoS-mediated stress responses.

Project description:Antibiotic therapy is the standard of care for urinary tract infections (UTIs) caused by uropathogenic Escherichia coli (UPEC). However, previous antibiotic therapy may impart a selective pressure that influences the population structure and pathogenic potential of infecting UPEC strains. Here, we conducted a 3-year study using whole-genome-sequencing analysis and retrospective medical record review to characterize how antibiotic exposure influenced the phenotypic antibiotic resistance, acquired resistome, virulome, and population structure of 88 UTI-causing E. coli strains from dogs. A majority of UTI-associated E. coli strains were from phylogroup B2 and clustered within sequence type 372. Previous antibiotic exposure was associated with a population shift toward UPEC from phylogroups other than the typical urovirulent phylogroup B2. The specific virulence profiles within the accessory virulome that were associated with antibiotic use were elicited by the effect of antibiotics on UPEC phylogenetic structure. Among phylogroup B2, antibiotic exposure increased the quantity of genes within the resistome and the odds of developing reduced susceptibility to at least one antibiotic. Non-B2 UPEC strains harbored a more diverse and greater resistome that conferred reduced susceptibility to multiple antibiotic classes following antibiotic exposure. Collectively, these data suggest that previous antibiotic exposure establishes an environment that provides a selective edge to non-B2 UPEC strains through their diverse and abundant antibiotic resistance genes, despite their lack of urovirulence genes. Our findings highlight the necessity for judicious use of antibiotics as we uncover another mechanism by which antibiotic exposure and resistance can influence the dynamics of bacterial infectious disease. IMPORTANCE Urinary tract infections (UTIs) are one of the most common infections of dogs and humans. While antibiotic therapy is the standard of care for UTIs and other infections, antibiotic exposure may influence the pathogenic profile of subsequent infections. We used whole-genome sequencing and retrospective medical record review to characterize the effect of systemic antibiotic therapy on the resistance, virulence, and population structure of 88 UTI-causing UPEC strains isolated from dogs. Our results indicate that antibiotic exposure alters the population structure of infecting UPEC strains, providing a selective edge for non-B2 phylogroups that harbor diverse and abundant resistance gene catalogues but fewer urovirulence genes. These findings highlight how antibiotic resistance can influence pathogen infection dynamics and have clinical implications for the judicious use of antibiotics for bacterial infections.