Prevalence of antimicrobial resistance in Escherichia coli and Klebsiella spp. in rural South India.

The emergence and dissemination of antimicrobial resistance (AMR) is an important public health problem as resistant organisms cause difficult-to-treat infections. In this study, the prevalence of AMR in Escherichia coli and Klebsiella spp. in rural South India was examined in order to aid empirical therapy. A cross-sectional prospective study was conducted during the period from January 2012 to December 2014. Routine clinical isolates of E. coli and Klebsiella spp. were tested for antimicrobial susceptibility to β-lactams, aminoglycosides, fluoroquinolones, tetracyclines, colistin and nitrofurantoin by the Kirby-Bauer disk diffusion method and the data were documented and analyzed with one per patient analysis using WHONET software. A total of 2292 non-duplicate clinical isolates were recovered during the study period, including 1338 E. coli and 954 Klebsiella spp. The prevalence of AMR in the total isolates was as follows: amikacin, 17.3%; ertapenem, 14.4%; doripenem, 4.5%; colistin, 13.2%; and tigecycline, 4.1%. The study results indicate a high prevalence of carbapenem resistance in Klebsiella spp. especially from pus and urinary isolates, whilst the prevalence of aztreonam and fluoroquinolone resistance was very high in E. coli.