Six-year antimicrobial resistance patterns of Escherichia coli isolates from different hospitals in Gaza, Palestine

BACKGROUND: Escherichia coli is the foremost agent responsible for infections in humans, encompassing those affecting the urinary tract, ears, wounds, and various other regions. The escalating global issue of antimicrobial resistance in E. coli is raising significant apprehension. The aim of this study was to assess the frequency and susceptibility to antibiotics of E. coli based on gender, age, and the type of specimen. METHODS: A retrospective review was conducted on culture outcomes from a total of 7,656 E. coli specimens primarily from urine, pus, sputum, vaginal swabs, and other specimens including cerebrospinal fluid (CSF), catheter tips, ear discharges and eye swabs, and ascitic fluid. Patients included 5,285 females (69%) and 2,371 males (31%), with age groups ranging from neonates (1 day to 29 days) to adults (> 12 years). The antimicrobial susceptibility was tested using the Kirby-Bauer disc diffusion method. RESULTS: E. coli strains displayed the highest levels of resistance to ampicillin and co-amoxiclav, with resistance rates reaching 90.3% and 78.7%, respectively. Conversely, these strains showed the lowest resistance to colistin (6.3%), followed by meropenem (9.9%) and amikacin (10.6%). Resistance patterns appeared to vary between males and females across most antibiotics, with similar trends observed across different age groups. Colistin resistance was notably higher among younger patients. Among the various specimen types analyzed, sputum samples generally exhibited the highest resistance rates for many antibiotics when compared to other specimen types. CONCLUSION: The resistance pattern of E. coli varies depending on gender, age, and specimen sources, and this should be taken into account when treating E. coli infections.