Jpn. J. Infect. Dis., 54 (2), 64-68, 2001
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Original Article
Prevalence of Resistance to Antimicrobials of Escherichia coli Isolates from Clinical Sources at a Private Hospital in Trinidad
Fitzroy A. Orrett* and Simone M. Shurland1
Department of Pathology and Microbiology, The University of the West Indies, Faculty of the Medical Sciences and 1College of Health Sciences, NIHERST, Medical Laboratory Technology Department, Eric Williams Medical Sciences Complex, Champs Fleurs, Trinidad and Tobago, West Indies
(Received November 28, 2000. Accepted March 1, 2001)
SUMMARY: Antimicrobial susceptibility patterns of strains of Escherichia coli isolated between 1994 and 1998 were studied. Of the 1,283 strains examined, 75% were recovered from urine, 8.7% from wounds, 3.2% from blood, 2.6% from pus, and 10.5% from other sources. Isolates from inpatients and outpatients accounted for 46.1% and 53.9%, respectively. Gentamicin and nalidixic acid showed the greatest efficacy against isolates from both inpatients and outpatients, revealing a >90% sensitivity. Drugs with the lowest efficacies were ampicillin and amoxicillin-clavulanic acid, which showed a >45% resistance. Tetracycline showed a significant decline in resistance from 1994 to 1998 among strains from both inpatients and outpatients (P < 0.001). This decline may be related to a policy of restrictive antibiotic reporting by the Microbiology Laboratory and seminars for general practitioners, subsequent to an island-wide survey an antibiotic resistance. A similar pattern of declining resistance was also observed for cefuroxime. E. coli sensitivity to co-trimoxazole was relatively stable during the study period. Although the overall prevalence of resistance among E. coli strains is relatively low, on-going surveillance of bacterial resistance must continue. The microbial antibiogram can provide general practitioners and clinicians with data essential for optimum empiric choices. Further, the introduction of a policy of restrictive reporting may act "synergistically" with the education of doctors on resistance patterns, to effect island- wide reduction of antimicrobial resistance.
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