SUMMARY
Objective: We aimed to investigate the type of produced b-lactamase in selected Escherichia coli strains as well to determine drug resistance to 22 antimicrobial agents.
Methods: Strains isolated from hospitalized patients were first identified in our laboratory and then we detected the type of produced b-lactamase in them by phenotypic methods. A colorimetric micro-method and a disc-diffusion test were used to determine sensitivity/resistance of E. coli isolates.
Results: From the total number of 371 examined multidrug-resistant E. coli strains included in the research, 364 (98 %) strains produced b-lactamase of the ESBL type and the remaining 7 (2 %) produced AmpC-type of b-lactamase. We detected no one type of carbapenemase production in all tested strain. Overall, the highest rate of resistance (above 50%) were detected within the University Hospital Bratislava (UHB) to ampicillin/sulbactam (76.8 %), cefuroxime (98.8 %), cefotaxime (98.2 %), ceftazidime (78.9 %), cefepime (83.4 %), ciprofloxacin (93,7 %), tetracycline (64.7 %), cotrimoxazole (trimethoprim/sulfamethoxazole) (75.5 %) and tobramycin (54.9 %). Within both hospitals belongigng to UHB (the Old Town hospital and the Specialized geriatric hospital), we noticed differences in antimicrobial resistance. Higher incidence of resistance in Old Town hospital vs. Specialized geriatric hospital was detected to ampicillin/sulbactam (79.4 % vs. 71.2 %), piperacillin/tazobactam (20.4 % vs. 12.7 %), cefuroxime (99.6 % vs. 97.1 %), cefotaxime (98.7 % vs. 97.1 %), ceftazidime (80.2 % vs. 76 %), cefoperazone/sulbactam (7.6 % vs. 22 %), cefepime (84.3 % vs. 81.3 %), amikacin (4.8 % vs. 1.9 %) and cotrimoxazole (76.7 % vs. 72.8 %). Antimicrobial resistance in the Specialized geriatric hospital was higher compared to the Old Town hospital in connection with the following antimicrobial agents: gentamicin (26.5 % vs. 25 %), ciprofloxacin (96.2 % vs. 92.5 %), tetracycline (69.8 % vs. 62.4 %), tigecycline (3.3 % vs. 0 %) and fosfomycin (4.2 % vs. 2 %).
Conclusions: Higher rate of antimicrobial resistance mainly to protected broad-spectrum penicillins and cephalosporins, amikacin and cotrimoxazole in the Old Town hospital vs. Specialized geriatric hospital, may indicate their higher consumption in the mentioned medical facility. On the other hand, antimicrobial resistance in the Specialized geriatric hospital may indirectly indicate an increasing consumption of ,,non-b-lactam“ antiinfectious agents (gentamicin, ciprofloxacin, tetracycline, tigecycline and fosfomycin) used in general for the treatment of infections in the geriatric patient population.
Key words: Escherichia coli, ESBL- b-lactamase, AmpC b-lactamase, multidrug resistance (MDR), antimicrobial resistance.
Lek Obz, 2022, 71 (1): 16-20
Zuzana HUBENÁKOVÁ, Ján KOREŇ
Institute of Microbiology, Faculty of Medicine, Comenius University and University Hospital Bratislava, head Assoc. prof. A. Liptáková, PhD.
Cite:
HUBENÁKOVÁ Z., KOREŇ J.: Antimicrobial resistance in Escherichia coli strains isolated from patients hospitalized in the University hospital Bratislava as well as development of this resistance. Lek Obz, 2022, 71 (1): 16-20
