Factors associated with carriage of multi-resistant commensal Escherichia coli among postmenopausal women in Ujjain, India

Abstract

There is paucity of surveillance studies on antibiotic resistance in commensal Escherichia coli. The main aim of this cross-sectional study was to determine factors associated with peri-anal carriage of multi-resistant E. coli by healthy postmenopausal women. A structured questionnaire was completed for consecutive healthy postmenopausal women aged 45 y and above attending the outpatient clinics of the Department of Obstetrics and Gynaecology at R.D. Gardi Medical College, Ujjain, India. Antibiotic susceptibility testing was done by the Kirby–Bauer disk diffusion method, as recommended in the Clinical and Laboratory Standards Institute guidelines. The study showed that 28% of healthy women carried multidrug-resistant (MDR) E. coli in the peri-anal region. The factors significantly associated with carriage of MDR E. coli were family size > 10 (OR 8.23, 95% CI 2.73–24.73; p < 0.001), antibiotic use in the past 2 weeks (OR 5.39, 95% CI 2.36–12.34; p < 0.001), and hospitalization in the past 2 weeks (OR 4.02, 95% CI 1.73–9.31; p = 0.001). This is the first study from India reporting the MDR E. coli carriage rate in healthy women aged over 45 y.

Keywords::

• Women
• commensal Escherichia coli
• multidrug-resistant
• India

Acknowledgements

We thank all the patients and staff for their co-operation during the data collection and Dr. V. K. Mahadik, Medical Director, R.D. Gardi Medical College, for administrative support during the project. This study was funded by the VR (the Swedish Research Council) and the Asia link. We thank the Erasmus Mundus External Cooperation Window lot 15 and the Swedish Research School for Global Health for scholarships to Ashish Pathak for his doctoral studies. The authors also wish to thank Rama V. Iyer and Binita Singh for their help with the microbiological analysis.

Declaration of interest: No conflicts of interest.