The comparative analysis of the antibiotic resistance profile of fecal enterobacteria isolated from medical students in Central and Southeast Asia

Ilya Azizov, Dmitriy Babenko, Alyona V. Lavrinenko, I. A. Belyaev, K. K. Toleubekov

2014

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DOI 10.1016/j.ijid.2014.03.666
Data confidence 70 medium
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Abstract

Background: The problem of antibiotic resistance spreading has reached the global level requiring animmediate actions. One of the possible way to spread out such microorganism is migration, including traveling due to foreign education. The aim of this study is to analyze the antibiotic resistance of microorganisms by Enterobacteriaceae family isolated from foreign medical students (India, Pakistan) and medical students of Kazakhstan studying at Karaganda State Medical University, Kazakhstan. Methods & Materials: From November 2011 to October 2013, 403 stains were isolated from stool samples from foreign medical students (India, Pakistan) and 109 isolates – from medical students from Kazakhstan. Bacterial identification was performed by using MALDI-TOF (Microflex, Bruker). Antimicrobial susceptibility testing has been carried out by disk diffusion and serial dilution method according to EUCAST criteria. Statistical analysis was done by WHONET 5.6 software. Results: The antibiogramm of E. coli (as the most frequently isolated microorganism) has shown higher level of resistance in the cases of students from South-East Asia then Kazakhstan's students strains: for ampicillin (69.6% (95%CI, 63,9 - 74,7%) versus 33.3% (95% CI, 17,95- 53,26%)), ceftazidime (59.5% (95% CI, 43.5-73.7%) versus 2.5% (95% CI, 0.5-12.9%), nalidixic acid (61.6% (95% CI, 56,6-66,4%) versus 41.4% (95% CI, 30,6-53,1%). There was no difference in resistance of E.coli, isolated from two groups (from India, Pakistan and Kazakhstan) of the students for: ampicillin/sulbactam (6.3% and 5.3%, p = 0.945), cefuroxime (70% and 72.7%, p = 0.801), cefotaxime (78.3% and 61.1%, p = 0.059), gentamycin (28.6% and 9.5%, p = 0.177), ciprofloxacin (38.8% and 26.9%, p = 0.063). ESBL activity of E.coli was detected at the same level in both groups (61% and 61.7%, p = 0,997). There was no resistance to carbapemens (imipenem and meropenem). Conclusion: Our study of antibiotic resistance of the fecal isolates from South-East and Central Asia students have shown the same level of ESBL-producers and absence of resistance to carbapenems, in spite of fact that there are number of publications about prevalence NDM-producing bacteria in Indian subcontinent. At the same time, higher level of resistance for some β-lactams and quinolones was found in group of students from South-East Asia.