Community acquired multi-drug resistant clinical isolates of Escherichia coli in a tertiary care center of Nepal.
BACKGROUND
Multi-drug resistance (MDR) in Gram-negative organisms is an alarming problem in the world. MDR and extensively-drug resistance (XDR) is in increasing trend due to the production of different types of beta (β)-lactamases. Thus the aim of this study was to document the incidence of MDR and XDR in clinical isolates of Escherichia coli and also to find out the enzymatic mechanisms of β-lactam antibiotics resistance.


METHODS
Two hundred clinical isolates of Escherichia coli (E. coli) identified by standard laboratory methods were studied. Antibiotic susceptibility profile was performed for all the isolates and the suspected isolates were phenotypically tested for the production of extended spectrum β-lactamase (ESBL), metallo β-lactamase (MBL) and AmpC β-lactamase (AmpC) by recommended methods.


RESULTS
Around three-fourth (78%) of the total isolates were multi-drug resistant. ESBL, MBL and AmpC production was found in 24%, 15% and 9% of isolates respectively. Amikacin, chloramphenicol and colistin were found to be the most effective antibiotics.


CONCLUSIONS
High percentage of MDR was observed. β-lactamase mediated resistance was also high. Thus, regular surveillance of drug resistance due to β-lactamases production and infection control policy are of utmost importance to minimize the spread of resistant strains.
Department of Microbiology, Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan Nepal.
Shamshul
S
Ansari
Department of Microbiology, Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan Nepal.
Hari Prasad
HP
Nepal
Department of Microbiology, Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan Nepal.
Rajendra
R
Gautam
Department of Microbiology, Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan Nepal.
Sony
S
Shrestha
Department of Microbiology, Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan Nepal.
Puja
P
Neopane
College of Nursing, Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan Nepal.
Ganga
G
Gurung
Department of Microbiology, Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan Nepal.
Moti Lal
ML
Chapagain
AmpC; ESBL; Escherichia coli; MBL; MDR; XDR