Detection of class 1 integron and antibiotic resistance of β-lactamase-producing Escherichia coli isolated from four hospitals in Babylon, Iraq

Background: The emergence of multidrug-resistant Escherichia coli is a major public health threat worldwide. Objectives: This study was conducted to determine the sensitivity pattern and class 1 integron of E. coli isolated from various clinical sources in Babylon, Iraq. Materials and Methods: A total of 1874 clinical samples were collected from patients between February and June 2022. Antimicrobial susceptibility of E. coli to different antibiotics was determined using the Vitek-2 compact system. Class 1 integron was detected genetically. Results: From 1874 clinical samples, 231 (12.3%) isolates belonged to E. coli. Isolates from urine were more frequent in females than in males. All isolates were resistant to ampicillin, amoxicillin, and amoxicillin/clavulanate. Escherichia coli isolates showed high sensitivity to meropenem, ertapenem, imipenem, amikacin, and isepamicin. Isolates from vaginal discharge were resistant to cephazolin, ciprofloxacin, levofloxacin, sparfloxacin, nalidixic acid, and aztreonam. Isolates from diabetic foot ulcer showed high resistance to ciprofloxacin, levofloxacin, sparfloxacin, nalidixic acid, norfloxacin, and ceftazidime. All E. coli isolates were multidrug-resistant (MDR) and 67% of them were extended-spectrum β-lactamase (ESBL) producers, most prevalent in urine and vaginal discharge. Approximately 99.1% of E. coli isolates carried class 1 integron. Conclusions: Escherichia coli isolated from various clinical specimens showed differences in antibiotic susceptibility patterns, with high resistance to commonly used antibiotics. The most effective antibiotics against E. coli isolates were ertapenem, imipenem, meropenem, amikacin, and isepamicin. However, MDR E. coli isolates showed high resistance rates to most of the antibiotics tested. ESBL-producing E. coli showed high prevalence. Class 1 integron is the leading cause of antibiotic resistance.