Out of 10 samples analyzed, 7 (70%) contained E. coli while 6 (60%) contained Klebsiella. Except one sample, all positive samples contained both E. coli and Klebsiella spp.
Colonies with green metallic sheen on EMB agar on further analysis were confirmed to be E. coli. Microscopic examinations revealed them to be gram negative non-capsulated bacilli (1SH, 2SH, 3TMC, 5LG, 8KZ, 9KZ, 10KZ). All the 7 isolates were motile, non-hydrogen sulfide producers; VP, citrate, oxidase negative while was indole, methyl red, catalase, urease, TSI (acid/acid with gas) positive. Pink colored, highly mucoid colonies in EMB Agar on further examinations were found to be Klebsiella pneumoniae. Microscopic examinations revealed them to be gram negative capsulated bacilli (1SH, 2SH, 3TMC, 5LG, 8KZ, 10KZ). All the 6 isolates were non-motile, non-hydrogen sulfide producers; indole, MR, oxidase negative while was VP, citrate, catalase, urease, TSI (acid/acid with gas) positive.
Out of 7 samples (n = 7) of E. coli, all the isolates were resistant to ampicillin, amoxicillin, cefoxitin, cefuroxime, and cefpodoxime. 85.7% of E. coli were resistant to amoxicillin/clavulanate and cephalosporins like ceftazidime, cefotaxime and ceftriaxone. The resistance shown by E. coli to aztreonam, Trimethoprim/sulfamethoxazole, nitrofurantoin, and gentamicin were 71.4%, 57.1%, 42.9%, and 28.6% respectively (Fig 1). 14.3% of strains were resistant to chloramphenicol and fluoroquinolones like ofloxacin, ciprofloxacin. All the strains were sensitive to azithromycin. Out of 7 isolates, 6 (85.7%) of E. coli (1SH, 2SH, 3TMC, 5LG, 9KZ, 10KZ) were multidrug resistant (MDR) bacteria. Notably 4 isolates (57.1%) of E. coli (1SH, 2SH, 9KZ, 10KZ) were confirmed as ESBL producing isolates.
Klebsiella pneumoniae were resistant to ampicillin, amoxicillin, and amoxicillin/clavulanate. 83.4% of Klebsiella were resistant to cefoxitin; while 66.7% were resistant to cefuroxime, ceftazidime, cefotaxime, ceftriaxone, and cefpodoxime (Fig 2). Klebsiella showed 50% resistant to aztreonam and Trimethoprim/sulfamethoxazole. 33.3% of strains were resistant to chloramphenicol, nitrofurantoin, ofloxacin, and ciprofloxacin. Only 16.7% of strains were resistant to azithromycin while were fully sensitive to gentamicin. Out of 6 Klebsiella, only 4 (66.7%) (1SH, 2SH, 3TMC, 8KZ) were MDR. Two isolates (33.3%) of Klebsiella (2SH, 8KZ) were confirmed to be ESBL producing isolates.
Multiple antibiotic resistance (MAR) indices of bacteria revealed that none of E. coli and Klebsiella were susceptible or resistant to all the seventeen tested drugs (Fig 3). Of all 7 E. coli, 1 (14.3%) was resistant to 6 drugs (MARI = 0.353), 1 (14.3%) was resistant to 9 drugs (MARI = 0.529), 3 (42.9%) were resistant to 11 drugs (MARI = 0.647), and 2 (28.6%) was to 14 drugs (MARI = 0.824). Of all 6 Klebsiella, 1 (16.7%) was resistant to 3 drugs (MARI = 0.176), 1 (16.7%) was resistant to 4 drugs (MARI = 0.235), 2 (33.3%) were resistant to 10 drugs (MARI = 0.588), 1 (16.7%) was resistant to 15 drugs (MARI = 0.882), and 1 (16.7%) was to 16 drugs (MARI = 0.941).