Prevalence and Antibiotic Resistance Profile of Multidrug Resistant and Extended-Spectrum β-Lactamase Producing Escherichia coli in a Nigerian Tertiary Hospital

Background: Escherichia coli (E. coli) infections pose significant challenges in healthcare settings due to increasing rates of antimicrobial resistance, especially multidrug resistance (MDR) and Extended β-lactamase (ESBL) production. Understanding the prevalence and antibacterial susceptibility profiles of E. coli isolates is important for guiding empirical therapy and implementing effective infection control measures. Aim: This study aimed to investigate the prevalence of multidrug resistance and extended-spectrum β-lactamase-producing E. coli in clinical sources from Rivers State University Teaching Hospital. Methods: This descriptive cross-sectional study analysed 300 clinical samples collected from patients presenting with suspected E. coli infections in Rivers State University Teaching Hospital. From the study sample, urine, stool, and wound swabs were collected. E. coli isolates were identified using standard microbiological techniques, and antibiotic susceptibility testing was performed using the disc diffusion method and confirmation of suspected ESBL-producing E. coli was done by using the double-disk approximation or double-disk synergy (DDS) method. The data generated from this study were represented as frequencies and percentages using chi-square with the aid of GraphPad Prism Software Version 9. Results: Among the 300 clinical samples analysed, E. coli growth was observed in 20.3% of samples, with urine samples being the most prevalent source (62.3%). Prevalence of MDR E. coli strains was recorded at 45.9% of isolates exhibiting multidrug resistance. Additionally, ESBL production was detected in 42.6% of isolates. Variable susceptibility patterns were observed across different antibiotic classes, with notable sensitivity rates observed for Amikacin (80.3%) and Gentamicin (78.7%), while resistance was observed in cephalosporins, fluoroquinolones, and β-lactam antibiotics. Notably, all E. coli isolates remained sensitive to imipenem. Conclusions: This study underscores the importance of vigilant surveillance and effective antibiotic stewardship programs to mitigate the spread of multidrug-resistant E. coli strains and ESBL-producing isolates. The varying susceptibility patterns observed highlight the need for tailored treatment approaches and comprehensive infection control measures to optimise patient outcomes. These findings emphasise the urgent need for collaborative efforts to address antimicrobial resistance and preserve the effectiveness of antibiotics in the management of E. coli infections.