Molecular analysis of multidrug-resistant E. coli in pediatric UTIs: findings from a Nigerian Hospital

Introduction: This study aimed to isolate and characterize antibiotic -resistant Escherichia coli from urine samples of children at the Mother and Child Hospital in Ondo State, Nigeria, assessing antibiogram profiling and resistance genes. Methodology: Three hundred urine samples (158 females, 142 males), aged 3-5 years, were collected, transported on ice, and analyzed bacteriologically. E. coli and Gram-negative bacteria were isolated using Eosin Methylene Blue agar and identified through colony morphology and biochemical tests. Antibiotic susceptibility was determined via Kirby Bauer's disc diffusion, and resistance genes were detected using Polymerase Chain Reaction (PCR). Results: Of the 300 samples, 40 (13.3%) yielded E. coli with varying antibiotic resistance profiles. The highest resistance was against Amoxicillin-clavulanate (87.5%) followed by Ceftriaxone (80%). Susceptibility was observed to Nitrofurantoin, Erythromycin, and Chloramphenicol. Multiple resistance patterns against 3-4 antibiotic classes were recorded, with 12 distinct patterns observed. Eight isolates harbored blaCTX-M gene, while five carried the aac3-IV gene. Conclusions: The study concluded a high occurrence of E. coli infection and multiple antibiotic resistance in the region. The presence of resistance genes suggests significant economic and health implications, emphasizing prudent antibiotic use under physician guidance to mitigate multiple antibiotic resistance.