Currently submitted to: JMIR Preprints
Date Submitted: Aug 8, 2025
Open Peer Review Period: Aug 8, 2025 - Jul 24, 2026
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Antibiotic Resistance, Haematological Impact, and Co-Prevalence of Parasitic Infections in E. coli O157:H7-Positive Patients in Southern Nigeria
ABSTRACT
Background:
Antibiotic resistance and intestinal parasitic infections represent significant public health challenges in Southern Nigeria. The prevalence of Escherichia coli O157:H7, a pathogenic strain often associated with severe gastrointestinal diseases, along with intestinal parasites such as Hookworm, Entamoeba histolytica, and Ascaris lumbricoides, raises concerns about effective treatment options and the overall health burden. This study aimed to explore the prevalence of these infections and their associations with clinical outcomes in hospital patients, focusing on antibiotic resistance patterns and their impact on health.
Objective:
The primary objectives of this study were to determine the antibiotic resistance patterns of E. coli O157:H7 isolates, compare haematological profiles in patients with and without E. coli O157:H7 infection, and assess the prevalence and factors influencing intestinal parasitic infections in the patient population.
Methods:
A cross-sectional study was conducted at Central Hospital, Benin City, Nigeria. A total of 420 stool samples were screened for intestinal parasites and E. coli O157:H7. Antibiotic susceptibility testing was performed using the disc diffusion method, and PCR was used for molecular confirmation of E. coli O157:H7. Haematological parameters were analyzed using an autoanalyzer. Prevalence data were compared across age groups, gender, and diarrhea status. Statistical analysis was performed using GraphPad InStat software.
Results:
The study revealed that all E. coli O157:H7 isolates were resistant to amoxicillin-clavulanate, cefuroxime, and cloxacillin, with 80% resistance to ceftriaxone and gentamicin. However, 100% susceptibility to ofloxacin was observed. The overall prevalence of intestinal parasites was low (1.90%), with hookworm being the most common infection. No significant differences in parasite prevalence were observed based on age, gender, or diarrhea status. Haematological parameters showed no significant difference between patients with and without E. coli O157:H7 infection.
Conclusions:
The findings highlight a significant challenge in managing E. coli O157:H7 infections due to high antibiotic resistance, while also indicating a need for targeted interventions for parasitic infections in specific regions. No major haematological impact was observed in E. coli O157:H7-infected patients. In the short term, it is crucial to enhance diagnostic capabilities and increase education on antibiotic resistance among healthcare providers to ensure accurate identification of pathogens and appropriate treatment. In the mid-term, establishing a national surveillance system for antimicrobial resistance (AMR) will allow for better monitoring of resistance patterns and inform treatment protocols. In the long run, efforts should be focused on improving sanitation infrastructure, particularly in rural areas, and implementing targeted deworming programs to reduce the prevalence of intestinal parasites. Thus, these interventions collectively aim to address both antimicrobial resistance and parasitic infections, ultimately improving public health outcomes. Thus, this study underscores the dual burden of antibiotic resistance and parasitic infections in Nigeria, emphasizing the urgent need for robust public health interventions and continuous surveillance to mitigate these health risks.
Citation
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