Antimicrobial resistance and beta-lactamase gene distribution among clinical isolates: a two-year cohort study

Abstract

A cohort investigation evaluated patient demographic information together with microbial detection patterns and antimicrobial drug resistance in a total group of 2,098 patients. Results showed an equally distributed sample consisting of 51.8% inpatients matched with 47.2% outpatients. In comparison, females comprised 51.8% of the total participants, and most patients fell within middle age categories and the elderly (58.5% aged 41-80 years). The patient demographic data showed that among 2,098 cases (14.7% were between 81 and 100 years old, and 1.2% reached the centenarian category thus demonstrating an increasing demand for geriatric healthcare services. Urine samples produced (72.9%) bacterial isolates above the combination of blood cultures and wound specimens (each with 9.7%). The comparison between 2022 and 2023 proved noteworthy, with healthcare facility admission rates escalating from 316 to 771 patient cases while outpatient walk-in numbers decreased from 587 to 403, along with a substantial rise in urinary tract infection isolates from 648 to 883 cases. The tests on antimicrobial resistance demonstrated that Imipenem (95%), along with Tigecycline (97%), were effective, but Norfloxacin (97.1%) and Cotrimoxazole (46%) had notable resistance patterns. The results showed an ESBL detection rate of 312 among Escherichia coli isolates, but MBL counts reached 83, and AmpC beta-lactamase production amounted to 142. blaCTX-M emerged as the leading ESBL gene type (38.1%) among a total of 142 collected E. coli strains, which also demonstrated blaOXA-48 (25.3%) and blaNDM (22.7%) as their prevalent MBL genes. Multiple resistance genes have become more prevalent in MBL isolates, as demonstrated by the simultaneous presence of blaVIM and blaNDM genes in (5.3%) of MBL isolates. The research results demonstrate the immediate requirement for better-controlling mechanisms in antimicrobial use and improved infection surveillance and control procedures following the detection of emerging resistance pathogens.

Keywords: Escherichia coli; Antimicrobial resistance; ESBLs; MBL; UTI.

Fig. 1

(A-C): Distribution of demographic characteristics of the study participants. (Fig. 1A) Distribution of Escherichia coli in IPD, OPD, and EXT patients. (Fig. 1B) Distribution of Escherichia coli in Male and Female patients. (Fig. 1C) Age-wise distribution of Escherichia coli in the patients of Aseer region.

Fig. 2

Distribution of Escherichia coli among the clinical samples.

Fig. 3

Antimicrobial susceptibility pattern of Escherichia coli in the Aseer region.

Fig. 4

Resistance trend of Escherichia coli during the period 2022–2023 in the Aseer region.

Fig. 5

Phenotypes associated with antimicrobial resistance among E. coli.