Prevalence and antimicrobial resistance patterns of Escherichia Coli isolated from patients with urinary tract infections

Abstract

 The World Health Organization in Vietnam has warned that antimicrobial resistance is an extremely serious issue for the country. Studies conducted both domestically and internationally in recent years have shown that the most common bacterial pathogens causing urinary tract infections are Enterobacterales, with E. coli being the leading species. The options for antibiotic treatment of infections caused by ESBL-producing Enterobacterales are limited. Objectives: To determine the isolation rate of E. coli and its antimicrobial resistance patterns, and to analyze factors associated with E. coli-related UTIs in patients. Methods: A cross-sectional descriptive study was conducted among patients diagnosed with UTIs at Long Khanh Regional General Hospital, who were indicated for quantitative urine culture and antimicrobial susceptibility testing. Results: The prevalence of E.coli causing UTIs was 50.4%. E.coli exhibited the highest resistance rates to Ampicillin (95.6%), Cefazolin (88.6%), Cefuroxime (85.3%), Ciprofloxacin (82.6%), Trimethoprim–sulfamethoxazole (68.0%), Ceftriaxone (67.9%), Ceftazidime (66.9%), Cefepime (60.3%), Ampicillin–sulbactam (37.5%), Gentamicin (34.2%), Piperacillin–tazobactam (18.5%), and Imipenem (10.3%). Lower resistance rates were observed for Ertapenem (8.2%), Meropenem (2.2%), and Nitrofurantoin (2.7%). The proportion of ESBL-producing E. coli was 48.4%, while carbapenemase-producing strains accounted for 8.7%. In multivariable logistic regression analysis, benign prostatic hyperplasia was significantly associated with E. coli UTIs (p = 0.033), whereas other factors such as diabetes mellitus, nephrolithiasis, JJ stent placement, and hypertension showed no significant association (p > 0.05). Conclusions: E. coli is the leading causative pathogen of UTIs in patients and demonstrates a high level of resistance to multiple classes of antibiotics.