Prevalence of resistance to antimicrobials of Escherichia coli isolates from clinical sources at a private hospital in Trinidad.
Antimicrobial susceptibility patterns of strains of Escherichia coli isolated between 1994 and 1998 were studied. Of the 1,283 strains examined, 75% were recovered from urine, 8.7% from wounds, 3.2% from blood, 2.6% from pus, and 10.5% from other sources. Isolates from inpatients and outpatients accounted for 46.1% and 53.9%, respectively. Gentamicin and nalidixic acid showed the greatest efficacy against isolates from both inpatients and outpatients, revealing a >90% sensitivity. Drugs with the lowest efficacies were ampicillin and amoxicillin-clavulanic acid, which showed a >45% resistance. Tetracycline showed a significant decline in resistance from 1994 to 1998 among strains from both inpatients and outpatients (P < 0.001). This decline may be related to a policy of restrictive antibiotic reporting by the Microbiology Laboratory and seminars for general practitioners, subsequent to an island-wide survey an antibiotic resistance. A similar pattern of declining resistance was also observed for cefuroxime. E. coli sensitivity to co-trimoxazole was relatively stable during the study period. Although the overall prevalence of resistance among E. coli strains is relatively low, on-going surveillance of bacterial resistance must continue. The microbial antibiogram can provide general practitioners and clinicians with data essential for optimum empiric choices. Further, the introduction of a policy of restrictive reporting may act "synergistically" with the education of doctors on resistance patterns, to effect island-wide reduction of antimicrobial resistance.
Orrett
F A
FA
Department of Pathology and Microbiology, the University of the West Indies, Faculty of Medical Sciences, Trinidad and Tobago, West Indies. drfao@tstt.net.tt
Shurland
S M
SM
D019980:Amoxicillin-Potassium Clavulanate Combination / Q000494:pharmacology; D000667:Ampicillin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002444:Cefuroxime / Q000494:pharmacology; D002511:Cephalosporins / Q000494:pharmacology; D004352:Drug Resistance, Microbial; D004926:Escherichia coli / Q000187:drug effects*; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000382:microbiology*; D005839:Gentamicins / Q000494:pharmacology; D016304:Hospitals, Private; D006801:Humans; D008826:Microbial Sensitivity Tests; D009268:Nalidixic Acid / Q000494:pharmacology; D010406:Penicillins / Q000494:pharmacology; D013752:Tetracycline / Q000494:pharmacology; D014300:Trinidad and Tobago
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D005839:Gentamicins; D010406:Penicillins; D009268:Nalidixic Acid; D019980:Amoxicillin-Potassium Clavulanate Combination; D000667:Ampicillin; D013752:Tetracycline; D002444:Cefuroxime