Objective: To study the mechanisms on drug susceptibility and resistance of clinically multidrug-resistant Escherichia coli isolates, to provide information on related treatment.
Methods: The susceptibility of E. coli strains that isolated from different kinds of samples in the last 3 years on drugs was analyzed by agar dilution test, with strains that exhibiting resistances to cefotaxime, ciprofloxacin and amikacin simultaneously collected for further analysis. Resistant genes which mediate resistance to β-lactamases, fluoroquinolone and aminoglycoside as well as phylogenic type were detected by PCR amplification while genetic relation was analyzed by PFGE. Transferability of resistant plasmids was identified by conjugation test.
Results: In total, 137 multidrug-resistant E. coli isolates were collected. Only 1% of the isolates exhibited resistance to both imipenem and meropenem while 4% of the strains were resistant to piperacillin/tazobactam. Most (85%) of the isolates were positive to ESBL and majority of them produced CTX-M. Target substitution and production of methylases were the main mechanisms causing resistance to fluoroquinolones and aminoglycosides respectively.
Conclusion: The main source of clinical multidrug-resistance was collected from urine samples. Carbapenem and enzyme inhibitor-containing antibiotics seemed to be the available antibiotics that were sensitivity to the clinically multidrug-resistant E. coli isolates.
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