High Prevalence of Antimicrobial Resistance Genes in Multidrug-Resistant Extended-Spectrum Beta-Lactamase-Producing Escherichia coli Clinical Isolates after COVID-19 Pandemic, North Iran.

Abstract

Background: Amid the COVID-19 pandemic, the surge in hospital admissions and widespread use of broad-spectrum antibiotics have heightened the risk of hospital-acquired infections from multidrug-resistant (MDR) organisms, particularly Escherichia coli. It is imperative to implement stringent measures to curb the spread of antimicrobial resistance in hospitals and devise robust treatment strategies for patients grappling with such infections. To confront this challenge, a comprehensive study was undertaken to examine MDR extended-spectrum beta-lactamase (MDR-ESBL)-producing Escherichia coli isolates from patients with nosocomial infections following the COVID-19 pandemic in Northern Iran.

Materials and methods: The current study was conducted as a cross-sectional study. A total of 12,834 samples were collected from patients with healthcare-associated infections at four designated corona centers in Northern Iran, following the COVID-19 pandemic. Antimicrobial resistance was determined using standard broth micro-dilution, while resistance genes were accurately detected using the multiplex PCR method.

Results: The results indicated that meropenem and ciprofloxacin had a resistance rate of 100% and 98.2%, respectively, while piperacillin-tazobactam showed the highest sensitivity rate at 54.4%. The frequency of specific genes, including bla _IMP , bla _TEM , AcrA, AcrB, bla _CTX , bla _OXA-58 , aaclb, bla _SHV, and aacla, were found to be 100%, 100%, 99.1%, 99.1%, 91.2%, 80.7%, 64.9%, 44.7%, and 37.7%, respectively.

Conclusions: In the current study, over 50% of MDR-ESBL-producing Escherichia coli isolates exhibited resistance to antibiotics. A combination of antibiotics, including piperacillin-tazobactam and colistin, is recommended for treating extensively drug-resistant Escherichia coli infections.