A Retrospective Study of the Antimicrobial Resistant Escherichia Coli, Klebsiella Pneumoniae and Pseudomonas Aeruginosa in Clinical Samples from a Healthcare Facility in Osogbo, Nigeria

Background: Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae are gram-negative bacteria that have been linked with various healthcare-associated and community-acquired infections. These three organisms have been identified as critical multi-drug resistant pathogens that require new drugs to combat their infections in humans. Due to the scarcity of data about the true burden of AMR in the 3 microorganisms in this locality, this study investigated the prevalence, pattern and trend of antimicrobial resistance exhibited by K. pneumoniae, P. aeruginosa and E. coli within Osogbo metropolis. Method: Antimicrobial resistance prevalence, patterns and trends in E. coli, K. pneumoniae and P. aeruginosa isolates from clinical samples submitted for microbial culture and sensitivity test between January and December 2022 were analyzed. In this study, nine antibiotics including Cefixime, Cefotaxime, Cefuroxime, Ceftriaxone, Gentamicin, Augmentin, Imipenem, Ciprofloxacin and Levofloxacin were selected based on the spectrum of activity. Data analysis was done using SPSS version 25 for statistical analyses. Results: There were 171, 83 and 32 isolates of E. coli, K. pneumoniae and P. aeruginosa identified in this study respectively. Overall, the three organisms showed higher AMR prevalence to IMP and ZEM, and least resistance to LBC. Essentially, 24 P. aeruginosa, 113 E. coli, and 59 K. pneumoniae isolates demonstrated multidrug resistance pattern. All P. aeruginosa isolates exhibited resistance to at least one antibiotic. AUG-CIP-CRO-CTX-CXM-GEN-IMP-LBC-ZEM resistance pattern occurred in both urine and wound samples for P. aeruginosa, as well as E. coli isolated from high vagina swab. Observed AMR in respect of carbapenem (IMP) and cephalosporin (cefuroxime, cefixime and cefotaxime) was above average for the 3 microorganisms. Patient age, nature and source of specimen are marginal factors influencing AMR of these isolates. Conclusion: This study identified the high rate of resistance by the bacterial isolates most especially to cephalosporins. The high MAR-index suggests the practice of self-medication due to unrestricted access to over-the-counter medications. Hence, there is the need for effective campaigns to sensitize the public on the need to halt indiscriminate use of antibiotics, as well as advocate for laws and policies to guide the sale and purchase of antibiotics at the community level.