Antimicrobial Resistance Pattern in Escherichia coli Isolated from Children Admitted at Selected Health Care Facilities in Moshi Municipality, Tanzania

Abstract

Background: Antimicrobial resistance (AMR) development among Gram negative bacteria has become a significant public health threat worldwide. Currently there are fewer antimicrobials available for treatment and prevention of some of bacterial infections. Antimicrobial resistance development in some of bacterial strains undermines empirical treatment regimens, thereby limiting choice of appropriate antibiotic. As this problem continues to grow, epidemiological surveillance is warranted to generate data that is reliable to understand the distribution of AMR among healthcare settings and geographical regions. Objective: The main objective of this study was to determine the prevalence and pattern of antibiotic resistance of Escherichia coli isolates from children admitted at selected health care facilities in Moshi municipality, Tanzania. This was descriptive cross sectional facility based study conducted from October 2017 to April 2018. The study aimed at answering the following questions; What are the carriage rates of Escherichia coli among children admitted at selected health facilities in Moshi municipality, What is the resistance rates of Escherichia coli isolated from children against the commonly used antibiotics in Moshi Municipality and What is the prevalence of the Extended spectrum beta lactamase producing Escherichia coli isolates from children admitted at health facilities in Moshi municipality? Results: Escherichia coli were isolated from all 282 cultured archived rectal swabs and all isolates were susceptible to amikacin and meropenem. Extended spectrum beta lactamase producers were 13.1% and 86.9% were nonextended spectrum beta lactamase producers. Antimicrobial resistance was detected in 282 isolates on the commonly used antimicrobial agents: ampicillin (83%), trimethoprim (75.9%), cefuroxime (32.6%), ceftriaxone (30.1%), ceftazidime (29.4%), ciprofloxacin (27.7%), amoxicillin/clavunic (24%), gentamicin (21%), chloramphenicol (16.3%) and piperacillin-tazobactam (8.1%). All Extended spectrum beta lactamase producing isolates were resistant to Ampicillin. Conclusion: Amikacin and meropenem is still the antibiotic of choice as a second line for treatment of infections caused by Escherichia coli. Majority of the isolates were resistant to ampicillin and Trimethoprim. Both ESBL and non ESBL producing Escherichia coli showed resistance to commonly used antibiotics, hence, further studies are warranted to understand mechanisms used by non ESBL producing Escherichia coli to develop resistance.