PREVALENCE OF MULTI-DRUG RESISTANT BACTERIAL GASTROENTERITIS IN KARACHI, PAKISTAN

• Main Authors: Sadia Zafar, Nimra Siddiqui, Rutaba Masroor, Sarah Ahmed, Syeda Rabab Hassan, Zainab Abdul Qadir
• Format: Article
• Language: English
• Published: Baqai University Press 2015-06-01
• Series: Baqai Journal of Health Sciences
• Subjects: Gastroententeritis; questionnaire; resistance; disc diffusion method; antimicrobials; E. coli
• Online Access: http://www.baqaiassets.com/bjhs/admin/articlefiles/1467264011upl1.pdf
• ISSN: 2312-4423; 2312-6884

Multidrug resistant Escherichia coli (E. coli) associated diarrheal diseases are the most prevalent health problems in Karachi, Pakistan. The main objective of the present study was to evaluate the clinical experiences of individuals suffered from gastroenteritis and also to determine the prevailing sensitivity / resistance pattern of E. coli among the population of Karachi. A cross-sectional retrospective survey was conducted by distributing questionnaires to a total of 150 individuals in December, 2014. The data collected from the questionnaire was statistically analyzed. Majority of the surveyed population was found to be infected by gastroenteritis lately or sometime in their life. On asking the questions about the possible reasons for being infected, it was revealed that the use of untreated water was the major source for the occurrence of the infection. Diagnostic tests were not carried out in most of the cases. Evaluation of questionnaire also indicated that physicians prescribed 2nd line of drug therapy due to the failure of treatment by cephalosporins, quinolones and fosfomycin. The susceptibility pattern of E. coli against selective antimicrobials agents was determined by using disc diffusion method. A total of 50 non-duplicate isolates of bacteria were collected from clinical laboratory of tertiary care hospital. The results were evaluated according to the guidelines of Clinical and Laboratory Standards Institute (CLSI). The findings of sensitivity determination supported the retrospective data indicating that cefexime and ceftriaxone failed to inhibit the growth of 80% of the bacterial sample while ciprofloxacin was also found to be less effective since 65% of the isolates showed resistance to it. A 50% resistance pattern was observed against cefoperazone and sulbactam. The most effective antibiotic against E. coli was found to be colistin (100% sensitive) followed by amikacin (90%), merepenem (90%) and gentamicin (70%). Hence, the in-time monitoring of infection through diagnostic procedures is suggested to avoid treatment failure.