Antibiotic Resistance Profile of Escherichia coli and Klebsiella pneumoniae Isolated from Patients with Cystitis

Abstract

   Urinary tract infections seem most important and prevalent hospital and community associated infections. It can be unimicrobial or polymicrobial with most prevalent microbes like Escherichia coli. And Klebsiella pneumoniae. It is hard to cured may be due to fluctuated antibiotic resistance mediated by arrays of mechanisms like modifying enzyme and efflux pumps. The study included 50 isolates of each E. coli. and K. pneumoniae confirmed by species specific genes, uidA and tryB. Antibiotic susceptibility for 25 antimicrobial agents were assessed. The results revealed that antibiotic susceptibility of E. coli, for penicillin and cephalosporin the results revealed that it is fully resist to amoxicillin, ceftazidime and cefotaxime while express moderate resistance to ceftriaxone (54%), cefixime (52%) and Cefoxitin (42%). The isolates express high sensitivity for piperacillin (74%). Also the susceptibility results to monobactam and carbapenem revealed that, (20%, 0.00% and 6% ) were resistant to Aztreonam, imipenem and meropenem respectively while high sensitivity were documented (96%, 80% and 56%) for imipenem and meropenem, Aztreonam respectively. For quinolones, the isolates show low resistance (26%, 14% and 12%) for ciprofloxacin , ofloxacine and levofloxacin respectively. At same time they are express high sensitivity rate (82% and 80%) to ofloxacin and levofloxacin respectively. Susceptibility of E. coli to aminoglycosides revealed that moderate resistance to kanamycin , streptomycin and tobramycin (42%, 36% and 20% respectively). High sensitivity were stated (94%, 62%, 50%, 50%) to netilmicine, gentamycin amikacin and tobramycin respectively. Also the isolates show high sensitivity to azithromycin (90%), trimethoprim (64%), doxycycline (62%) and nalidixic acid (62%).The results of K. pneumoniae susceptibility revealed that high resistance to penicillins and cephalosporins (ceftazidime 98%, ceftriaxone 92%, cefotaxime 92%, amoxicillin 92%, cefixime 84% and cefepime 80%). It is only sensitive to piperacillin (66%). Additionally the isolates express high sensitivity to meropenem (86%), and imipenem (76%) while moderate resistance to Aztreonam (58%). Quinolones susceptibility results reveal that, they are highly sensitive to ofloxacin (90%) and moderate sensitivity to levofloxacin (58%) and ciprofloxacin (46%). High level of sensitivity were conveyed to netlimicin (92%), amikacin (82%) and moderate sensitivity to gentamycin (52%) while high resistance was for streptomycin (78%). They show high sensitivity to azithromycin (76%) and nalidixic acid (68%) while express high resistance to trimethoprim (76%) and nitrofurantion (58%). The current study conclude that, the most suitable drugs for UTIs-associated E. coli/K. pneumoniae were piperacillin, netilmicine, amikacin, imipenem, meropenem, levofloxacin. There is an increased emergence of resistance to cephalosporins along nitrofurantion and trimethoprime.