Abstract
OBJECTIVE: In Pakistan, the rising rate of Escherichia coli (E. coli) resistance has been reported, leading to limited treatment options and contributing to a high morbidity and mortality ratio. This study aimed to analyze changes in antibiotic resistance patterns against commonly prescribed antibiotics in a tertiary care hospital in Lahore, Pakistan, over the span of 10 years. METHODOLOGY: A retrospective cross-sectional study was designed to analyze a decade-long (2013-2022) resistance trend of E. coli isolates identified at a tertiary care Shalamar Hospital in Lahore, Pakistan. The frequency of E. coli isolated from different infectious sites across various age groups and their resistance proportions against CLSI-recommended antibiotics was accessed for 10 years. RESULTS: E. coli is a Gram-negative bacterium that has caused a wide range of infections, predominantly urinary tract infections, with increasing antibiotic resistance. The results indicate a resistance rate of 98% to ampicillin, 93% to amoxicillin/clavulanic acid, and 87% and 82% to second and third-generation cephalosporins: cefuroxime, cefotaxime and ceftriaxone, respectively. High susceptibility against carbapenems and polymyxins drugs was also reported. However, over 10 years, an increasing resistance trend was observed against cefuroxime and imipenem and a significant decreasing trend was observed against gentamicin and nitrofurantoin. Likewise, resistance against beta-lactam like cefotaxime, ceftriaxone, and cefuroxime significantly increased compared to imipenem and meropenem compared to mean antibiotic resistance across all age groups. CONCLUSION: It highlights the emerging resistance trend against commonly prescribed antimicrobial drugs, leading to understanding the longitudinal resistance trends of E. coli in the region.