Antimicrobial Resistance Patterns in Escherichia coli Isolates from a Tertiary Care Teaching Hospital in Eastern India

Background: Antimicrobial resistance (AMR) among Escherichia coli has emerged as a major public health concern globally, particularly in low- and middle-income countries where antibiotic consumption is high and stewardship programs are still evolving. E. coli remains the leading cause of community- and hospital-acquired urinary tract infections (UTIs), and increasing resistance to commonly used antimicrobials has significantly limited therapeutic options. Aim: To determine the antimicrobial resistance patterns of E. coli isolates recovered from clinical samples and to analyze department-wise susceptibility trends at a tertiary care teaching hospital in Bihar, India. Methods: A hospital-based observational study was conducted in the Department of Microbiology, Jawaharlal Nehru Medical College, Bhagalpur, from 5 February 2025 to 31 December 2025. A total of 65 non-duplicate E. coli isolates obtained from various clinical samples were included. Identification and antimicrobial susceptibility testing were performed using standard microbiological techniques and interpreted as per CLSI guidelines. Data were analyzed using descriptive and inferential statistics. Results: E. coli constituted the predominant uropathogen. High susceptibility was observed to amikacin and gentamicin, while markedly reduced susceptibility was seen for fluoroquinolones and third-generation cephalosporins. Carbapenem resistance, though less frequent, was detected and showed inter-departmental variation. Conclusion: The study demonstrates a high burden of multidrug-resistant E. coli isolates with preserved susceptibility to aminoglycosides. Continuous surveillance through antibiograms and rational antibiotic stewardship are essential to curb the progression of AMR.