Multidrug resistant AmpC β-lactamase producing Escherichia coli isolated from a paediatric hospital

Area of Science:

• Microbiology
• Infectious Diseases
• Clinical Pharmacy

Background:

• AmpC β-lactamases are enzymes that confer resistance to a wide range of beta-lactam antibiotics.
• Escherichia coli (E. coli) is a common bacterium that can cause various infections.
• Antimicrobial resistance in E. coli is a significant global health threat.

Purpose of the Study:

• To investigate the prevalence of AmpC β-lactamase producing E. coli.
• To determine the antimicrobial resistance patterns of these isolates.
• To identify risk factors associated with infections caused by AmpC β-lactamase producing E. coli.

Main Methods:

• Isolation of E. coli from 20,257 pathological samples at The Children's Hospital and Institute of Child Health, Lahore, Pakistan.
• Identification of AmpC β-lactamase activity using the Disc Potentiation method in ceftazidime-resistant isolates.
• Antimicrobial susceptibility testing to assess resistance patterns.

Main Results:

• Out of 670 E. coli isolates, 85 (12.6%) were identified as AmpC β-lactamase producers.
• High resistance rates (100%) were observed against co-amoxiclav, ceftazidime, cefotaxime, cefuroxime, cefixime, ceftriaxone, and cefoxitin.
• Low resistance was noted for imipenem and meropenem (0%), piperacillin-tazobactam (5.9%), and cefepime (7.1%).
• Risk factors associated with these infections included intravenous lines (76.5%), endotracheal tubes (22.4%), surgery (12.9%), and urinary catheters (7.1%).

Conclusions:

• AmpC β-lactamase producing E. coli exhibit significant resistance to multiple antibiotics.
• Invasive devices and antibiotic stewardship are critical in controlling the spread of these resistant organisms.
• Effective infection control strategies are essential to combat antimicrobial resistance.