Escherichia coli as Possible Agents of Spread of Multidrug Resistance in Port Harcourt, Rivers State.

Abstract Multidrug resistance (MDR) continues to be a growing global issue. The problem of MDR is fuelled in part by the spread of the genes encoding resistance horizontally which is linked particularly to conjugation involving plasmids. Studies have demonstrated the presence of plasmids in drug resistant isolates, few have shown a link between these plasmids and drug resistance via plasmid curing especially in our locale. This study set out to explore this link in Escherichia coli isolates from Port Harcourt, Nigeria. Plasmid curing was done on a selection of clinical and non-clinical bacteria using acridine orange and antibiotic susceptibility testing carried out on both cured and uncured variants. Data generated was analysed to ascertain the multiple antibiotic resistance (MAR) index and MDR of each isolate. Data was then compared to ascertain effects of plasmid curing on antibiotic resistance of the isolates. Results revealed a decrease in resistance to 7 of 8 antibiotics following plasmid curing. The highest change was noted in ceftazidime (40%), followed by ofloxacin (26.7%). Plasmid curing caused a shift in MAR index values of isolates from higher to lower indices. At MAR index values of ≤0.25 occurrence increased from 5% to 36.7% while at MAR index values ≥0.75, occurrence reduced from 29.9% to 10.0%. A reduction in the degree of MDR was noted (from 55% to 36.7%). Strikingly, the reduction in MDR level of non-clinical isolates was 30% as opposed to 3.4% in the clinical isolates. This study shows a link between plasmids and antibiotic resistance. For the non-clinical isolates, the high-level link between MDR and plasmid carriage could indicate a higher use of antimicrobials in non-clinical rather than clinical settings. Additionally, it could be an indicator for a higher risk of the transfer of MDR determinants from non-clinical sources to human populations in our locale.