Antibacterial Resistance Profile of Enterobacterales and Patient-Related Risk Factors in Northeast Algeria

In this retrospective study, performed between January 2020 and December 2021, three different clinical specimens’ urine, blood, and pus from in and outpatients at Khenchela hospitals, North East of Algeria were analyzed. The profile of antibiotic susceptibility was characterized using the disk diffusion method. Out of the 1979 clinical specimens analyzed, 279 samples tested positive for bacterial infection with Escherichia coli as the most frequent strain isolated (about 55% of all cases). We found that all the isolated strains (E. coli, Enterobacter spp., Klebsiella spp., and Proteus spp.) were multidrug-resistant but showed high susceptibility to amoxicillin/clavulanic acid (29.7%). We found that Enterobacter spp. has a higher likelihood of developing resistance, it was 10.68-fold colistin-resistant, 3.6-fold imipenem resistant, 3.23-fold ciprofloxacin resistant, and 3.03-fold cefotaxime resistant more than the other groups. In contrast, E. coli exhibited the lowest resistance rates compared to all tested groups and was the most susceptible to the antibiotics evaluated. The logistic regression reveals that the variable “year” was significantly associ¬ated with changes in bacterial susceptibility patterns in three species Klebsiella spp., Proteus spp., and E. coli against four antibiotics ampicillin, ofloxacin, colistin, trimethoprim/sulfamethoxazole. For the variable “origin” the odds of resistance recorded were significant in E. coli against amoxicillin/clavulanic acid and imipenem and in Klebsiella sp. against amikacin, where antibiotic resistance is more relevant in outpatient. Finally, we revealed that gentamicin is less effective against E. coli for females than males (odds ratio = 0.33).