Antimicrobial Resistance Pattern and multi drug resistancefrequency in Escherichia coli Strains Isolated from Patients Referred toTeaching Hospitals in Mazandaran Province, Iran

Background and Aim : Urinary tract infections are among the most common infections in bothoutpatients and inpatients worldwide. Due to the widespread empiric antibiotic treatment used, theresistance of common microorganisms to antibiotics has significantly increased. The present studywas designed to investigate the pattern of drug resistance in Escherichia coli strains isolated frompatients.Methods : In this cross-sectional study, ۱۰۰ urine samples completely randomly were taken frominpatients (more than ۴۸ hours) and outpatients. After confirmation of E. coli strains, Susceptibilitypatterns of isolates were assessed by disc diffusion methods according to the Clinical LaboratoryStandard Institute (CLSI) guidelines.Results : Based on the antibiogram results, the resistance of isolated isolates was reported asampicillin (۶۶.۶%), ampicillin-sulbactam (۶۲.۸%), Cotrimoxazole (۶۰.۷%), Cefazolin (۵۲%),Cefotaxime (۳۸.۶%), Tetracycline (۳۵.۵%), Ceftazidime (۳۴.۸%), Ceftriaxone (۳۳.۷۵%), Nalidixicacid (۳۳.۴%), Ciprofloxacin (۳۳.۲%), Piperacillin (۳۳%), Amoxyclav (۲۷.۶%), Nitrofurantoin(۱۹.۸%), Gentamicin (۱.۷%), Cefoxitin ( ۱.۲%) and imipenem (۱%) while resistance to amikacinand tobramycin was not found. Between outpatients (۵۳%) and inpatients (۴۷%), The mostresistant antibiotics in outpatients were ampicillin (۶۵%) and ampicillin-sulbactam (۵۵%) and thelowest resistance was to Cefotaxime (۳۱/۱%). The highest resistance of isolated isolates reportedin inpatients was Cefotaxime (۶۸.۹%), Ceftriaxone (۶۶.۶%), Ceftazidime (۶۰.۲%) and the lowestresistance rate is ampicillin (۳۵%). Among all the ۱۰۰ isolates, the frequency of MDR E.coli was۴۴% in urinary culture samples, while ۵۶% non-MDR were found, and (۴۵.۴۲%) were not resistantto any antibiotics. ۲۸.۵۷% and ۲۵% among them, were resistant to one or two antibioticsrespectively. Based on ۴۴ cases of MDR E.coli, ۷۲.۷% were women and ۲۷.۳% were men.Resistance rates of MDR E.coli isolates from inpatients (۵۶.۸%) were significantly higher thanoutpatients (۴۳.۲%). Moreover, the higher levels of MDR E.coli was reported based on the age of۶۵-۸۰ were (۲۲.۷۲%) and ۲۵-۴۵ were (۱۵.۹%), and the lowest levels of MDR E.coli in ۱۰-۲۵ (۹%)was reported.Conclusion : Carbapenems and aminoglycosides, especially amikacin and gentamicin, due to theirhigh sensitivity, can be one of the treatment lines for the treatment of urinary tract infections inhospitalized patients.