4. PREVALENCE OF ANTIMICROBIAL RESISTANT E-COLI FROM PATIENTS WITH SUSPECTED URINARY TRACT INFECTION IN ADO EKITI HOSPITAL

PREVALENCE OF ANTIMICROBIAL RESISTANT E-COLI FROM PATIENTS WITH SUSPECTED URINARY TRACT INFECTION IN ADO EKITI HOSPITAL

ABSTRACT

The study investigated the prevalence of antimicrobial resistant e-coli from patients with suspected urinary tract infection in Ado Ekiti hospital. The antibiotic resistance was determined in compliance with Bauer Kirby Susceptibility Standard. The study shows that the antimicrobial susceptibility of the isolate were predominant to antibiotics such as amoxicillin, Gentamycin and Rocephin. The study shows that a high percentage of E. coli isolated from the isolates were resistant to all the antibiotics Urinary tract infections (UTIs) are a common healthcare concern, often caused by Escherichia coli (E. coli), and are typically managed with antibiotics. However, the emergence of antimicrobial resistance among E. coli strains is jeopardizing the effectiveness of traditional UTI treatments. This study addresses the pressing issue of antimicrobial resistance in the context of UTIs, focusing on the prevalence of resistant E. coli among patients with suspected UTIs. Through systematic data collection and analysis, this study aims to provide valuable insights for healthcare providers, policymakers, and researchers. By understanding the current status of antimicrobial resistance, we can develop informed strategies to manage UTIs effectively and preserve the effectiveness of antibiotics. The study’s findings are expected to inform local treatment guidelines, promote antibiotic stewardship, enhance infection prevention and control measures, and ultimately contribute to the global efforts to combat antimicrobial resistance. With this research, we take a significant step toward addressing the challenges posed by resistant E. coli in UTIs and ensuring the well-being of patients and the integrity of healthcare systems.

CHAPTER ONE

1.0 INTRODUCTION

Antibiotic usage is possibly the most important factor that promotes the emergence, selection and dissemination of antibiotic-resistant microorganisms in both veterinary and human medicine (Daniels et al., 2009). This acquired resistance occurs not only in pathogenic bacteria but also in the endogenous flora of exposed individuals (animals and humans). In intensively reared food animals, antibiotics may be administered to whole flocks rather than individual animals, and antimicrobial agents may be continuously fed to food animals such as poultry, goats, and cattle as growth promoters. Therefore, the antibiotic selection pressure for bacterial drug resistance in the animal is high and invariably their faecal flora contains a relatively high proportion of resistant bacteria (Whitworth et al., 2008; Literal et al., 2010).

The mechanism for spreading antibiotic resistance from animals to humans and vice versa remains controversial. Colonization of the intestinal tract with resistant Escherichia coli from chicken has been shown in human volunteers and there is historical evidence that animals are a reservoir for E. coli found in humans (Akwar et al., 2008; Kikuvi et al., 2010). Furthermore, spread of antibiotic resistance plasmids in E. coli from chickens to human handlers or of antibiotics – resistant microorganisms from animal to humans in various countries has been reported (Fang et al., 2008).

Resistance has been found in organisms common to both humans and animals, such as E. coli, Salmonella spp., Campylobacter spp. and Enterococcus among others (Davis et al., 2009). Due to the intricate balance of microflora of different habitats within the ecosystem, the transfer of resistance genes among bacteria occupying different habitats has the potential to occur frequently.

Resistance genes may be transferred vertically among bacteria of different genera and families or horizontally among different bacterial species within the same genus or family (Call et al., 2008).Widespread reliance on antimicrobials in food animal production has resulted in a considerable rise of antimicrobial-resistant strains of bacteria, complicating the treatment of infectious diseases in livestock, companion animals, and humans. This has led to important changes in the perceptions and priorities of regulatory agencies with regard to antimicrobial usage, particularly the use of antimicrobials as growth promoters and prophylactic agents. The selective pressure from the use of antimicrobial agents at sub therapeutic levels in dairy cattle could result in the selection of those strains that contain genes for antimicrobial resistance (Call et al., 2008).

The prevalence of antimicrobial-resistant E. coli in patients with suspected urinary tract infections (UTIs) can vary depending on several factors, including geographical location, the specific patient population, the type of healthcare facility, and antibiotic prescription practices. To get accurate and up-to-date prevalence information, one would need to refer to scientific studies, public health reports, or healthcare databases that track antibiotic resistance in urinary tract infections. E. coli is a common cause of UTIs, and antimicrobial resistance in E. coli has been a growing concern worldwide. The prevalence of antimicrobial-resistant E. coli in UTIs varies, but it’s not uncommon to find resistance to commonly prescribed antibiotics, such as trimethoprim-sulfamethoxazole and fluoroquinolones, in some regions.

The actual prevalence of antimicrobial resistance can change over time due to various factors, including antibiotic usage patterns, local antibiotic resistance trends, and the emergence of new resistance mechanisms.

1.1 Statement of the problem

Urinary tract infections (UTIs) represent one of the most common bacterial infections worldwide, with Escherichia coli (E. coli) being the predominant causative pathogen. UTIs, if left untreated or ineffectively managed, can lead to severe complications, including pyelonephritis, sepsis, and chronic kidney diseases. To combat UTIs, antibiotics are often prescribed. However, the emergence and increasing prevalence of antimicrobial resistance among E. coli strains, especially in the context of UTIs, pose a significant public health threat. The problem at hand revolves around the following key issues:

Rising Antimicrobial Resistance: Antimicrobial resistance in E. coli isolates from patients with suspected UTIs is on the rise, challenging the effectiveness of common antibiotics used in UTI treatment. This resistance is fueled by the overuse and misuse of antibiotics, both in clinical settings and non-clinical environments.

Limited Treatment Options: Increasing resistance levels limit the available treatment options for patients with UTIs, leading to higher rates of treatment failure and complications. This raises concerns about the long-term management of UTIs and the potential need for newer, more potent antibiotics.

Public Health Implications: Antimicrobial-resistant UTIs not only lead to increased healthcare costs but also result in the spread of resistant strains in communities. This has far-reaching public health implications as resistant strains can infect others and undermine the overall effectiveness of antibiotics.

Therefore, this research seeks to address these challenges by conducting a systematic investigation into the prevalence and patterns of antimicrobial resistance among E. coli strains isolated from patients with suspected UTIs in Ado Ekiti hospital.

1.2 Justification of the Study

The study will be of great importance to the general public and health practitioners as it enlighten them on the appropriate use of antibiotics since extensive use of antibiotics in the healthy, agriculture, especially for prophylactic and growth promoting purposes as this have contributes significantly to increased frequencies and dissemination of resistance genes into other ecosystems.

1.3 Aim and Objectives of the study

The aim of this study is to investigate the microbial resistance of E. coli isolates from patients with suspected urinary tract infection in Ado Ekiti Hospital

The specific objectives of the study include:

I. To determine the antimicrobial resistance profile for E. coli strains from the sampled patient

II. To ascertain the microbial load of E. coli isolated from the selected patients attending Ado Ekiti Hospital

III. To analyze the antibiotic resistance rates for E. coli strains from the different Patient