Factors related to fecal carriage of multidrug-resistant-ESBL producing Escherichia coli in drug users from southwest Iran

Backgrounds: The escalating prevalence of multidrug-resistant (MDR) commensal intestinal bacteria characterized by extended-spectrum β-lactamase (ESBL) production is an alarming global health threat. Drug users have been introduced as a major source of antibiotic-resistant bacteria, possibly due to drug abuse. The present study aimed to investigate the potential factors related to fecal carriage of MDR ESBL-producing intestinal Escherichia coli (E. coli) in drug users in the southwest of Iran. Materials & Methods: In this cross-sectional study, stool samples of ۱۰۹ drug users were collected and cultured. After the biochemical confirmation of E. coli isolates, the antimicrobial resistance pattern and ESBL production of the isolates were determined. Then logistic regression analysis was conducted to determine possible factors related to fecal carriage of MDR ESBL-producing intestinal E. coli. Findings: Logistic regression analysis indicated that increasing age and duration of addiction were associated with increased risk of MDR ESBL-producing E. coli carriage in the intestinal flora of drug users (p< .۰۵). Moreover, oral drug use compared to the smoking method led to a higher carriage rate of MDR ESBL-producing E. coli in the intestinal flora of drug users (p< .۰۵). Also, self-employed drug users compared to those with fixed public occupation showed higher rates of MDR ESBL-producing E. coli carriage in their intestinal flora (p< .۰۵). Conclusion: Age, duration of addiction, method of drug use, and occupation were significantly associated with MDR ESBL-producing E. coli colonization.

Keywords:

Drug users , Intestinal Escherichia coli , MDR , ESBLs , Risk factors , Logistic regression analysis