Antimicrobial Susceptibility Profiles of Escherichia coli Isolated from Urine Samples Processed at Pathology Laboratories in 2024

Abstract

Escherichia Escherichia coli (E.coli) is a major etiological agent of Urinary tract infections (UTIs) worldwide. The increasing prevalence of multidrug-resistant (MDR) E. coli strains has compromised the effectiveness of commonly used antibiotics, posing a major challenge in clinical management. This study aimed to assess the antimicrobial susceptibility profiles of E. coli isolated from urine samples processed at Pathology Laboratories in 2024. A retrospective cross-sectional study was conducted using microbiology records from January to December 2024, analyzing a sample size of 190 E. coli isolates. Purposive sampling was first used to select urine samples positive for E. coli, followed by random sampling to ensure representativeness of the final sample. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method against 20 antibiotics. The results showed that E. coli infections were more prevalent in females (70.5%) than males (29.5%), with the highest infection rates observed in the 31–40 and 61+ age groups. High resistance rates was recorded for Levofloxacin (98.9%), Ampicillin (92.1%), Nitrofurantoin (76.3%), Nalidixic Acid (66.3%), and Cotrimoxazole (60%), while moderate resistance was observed for Tetracycline (52.6%) and Cefepime (41.1%). Cephalosporins (Ceftriaxone (93.7%), Cefuroxime (90.5%), and Ceftazidime (91.6%)) exhibited high effectiveness, and Carbapenems (Imipenem and Meropenem) and Chloramphenicol demonstrated complete susceptibility (100%). The study underscores the urgent need for enhanced antimicrobial stewardship programs, continuous surveillance of resistance trends, and strict Infection Prevention and control (IPC) measures. Clinicians should prioritize definitive therapy based on rapid and accurate antibiotic susceptibility testing rather than relying on empirical treatment, ensuring targeted and effective management of E. coli-associated UTIs while minimizing the risk of antimicrobial resistance. Public health interventions should focus on raising awareness about responsible antibiotic use. Strengthening laboratory-based surveillance and infection prevention strategies is critical to mitigating the spread of resistant E. coli strains and improving treatment outcomes.