Antibiotic Resistance Profile of Escherichia coli Isolated from Stool Samples of COVID-19 Patients

Abstract

Background: Antimicrobial resistance (AMR) poses a serious worldwide threat besides causing several concerns for the health system. E. coli has evolved to be capable of acquiring antibiotic resistance characteristics from other bacteria in its environment and of being easily transferred via fecal-oral route. However, this concern has not received enough attention during the last COVID-19 pandemic. Aim: To evaluate the antimicrobial profile of fecal E. coli isolated from COVID-19 patients. Subjects and methods: This study was conducted on 180 patients divided into two groups: the group of COVID-19 patients and the group of non-COVID-19 patients (90 each). Fecal samples were subjected to microbiology procedures for isolation and identification of E. coli strains. The identified strains were subjected to antimicrobial susceptibility testing using Kirby-Beuer test (disc diffusion method) and interpreted according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: The study found that a substantial proportion (82.2%) of patients with COVID-19 received azithromycin. Furthermore, the COVID-19 group demonstrated a significantly higher resistance to ertapenem compared to the non-COVID-19 group (8.9% versus 0%). Notably, E. coli isolates from COVID-19 patients exhibited a considerably higher multi-drug resistance (MDR) profile than those from non-COVID-19 patients (55.3% versus 44.7%). Conclusion: E. coli isolated from fecal samples of COVID-19 patients showed resistance to many tested antibiotics . Although, they showed significant resistance to ertapenem, the most efficient drugs against E. coli were the carbapenems. MDR E. coli was observed in both groups signifying community-acquired resistance. However, significant MDR pattern was detected among COVID-19 patients