Antimicrobial resistance profiles of Escherichia coli isolated from clinical and environmental samples: findings and implications

Maisa Kasanga; Doreen Mainza Shempela; Victor Daka; Mark J Mwikisa; Jay Sikalima; Duncan Chanda; Steward Mudenda

doi:10.1093/jacamr/dlae061

Antimicrobial resistance profiles of Escherichia coli isolated from clinical and environmental samples: findings and implications

JAC Antimicrob Resist. 2024 Apr 27;6(2):dlae061. doi: 10.1093/jacamr/dlae061. eCollection 2024 Apr.

Authors

Maisa Kasanga¹, Doreen Mainza Shempela², Victor Daka³, Mark J Mwikisa⁴, Jay Sikalima², Duncan Chanda⁵, Steward Mudenda⁶

Affiliations

¹ Department of Epidemiology and Biostatistics, School of Public Health, Zhengzhou University, Zhengzhou, China.
² Laboratory Department, Churches Health Association of Zambia, CHAZ COMPLEX Meanwood Drive (off Great East Road), Plot No. 2882/B/5/10, P.O. Box 34511, JC9H+VFF, Lusaka, Zambia.
³ Public Health Department, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia.
⁴ Department of Pathology and Microbiology, Lusaka Trust Hospital, Plot 2191, H8CC+52F, Nsumbu Rd, Woodlands, Lusaka, Zambia.
⁵ Adult Centre of Excellence, University Teaching Hospital, Lusaka, Zambia.
⁶ Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia.

Abstract

Background: The overuse and misuse of antimicrobials has worsened the problem of antimicrobial resistance (AMR) globally. This study investigated the AMR profiles of Escherichia coli isolated from clinical and environmental samples in Lusaka, Zambia.

Methods: This was a cross-sectional study conducted from February 2023 to June 2023 using 450 samples. VITEK^® 2 Compact was used to identify E. coli and perform antimicrobial susceptibility testing. Data analysis was done using WHONET 2022 and SPSS version 25.0.

Results: Of the 450 samples, 66.7% (n = 300) were clinical samples, whereas 33.3% (n = 150) were environmental samples. Overall, 47.8% (n = 215) (37.8% clinical and 10% environmental) tested positive for E. coli. Of the 215 E. coli isolates, 66.5% were MDR and 42.8% were ESBL-producers. Most isolates were resistant to ampicillin (81.4%), sulfamethoxazole/trimethoprim (70.7%), ciprofloxacin (67.9%), levofloxacin (64.6%), ceftriaxone (62.3%) and cefuroxime (62%). Intriguingly, E. coli isolates were highly susceptible to amikacin (100%), imipenem (99.5%), nitrofurantoin (89.3%), ceftolozane/tazobactam (82%) and gentamicin (72.1%).

Conclusions: This study found a high resistance of E. coli to some antibiotics that are commonly used in humans. The isolation of MDR and ESBL-producing E. coli is a public health concern and requires urgent action. Therefore, there is a need to instigate and strengthen interventional strategies including antimicrobial stewardship programmes to combat AMR in Zambia.