Antibiotic Resistance Profile, Multidrug-, Extensively drug-, and Pandrug-Resistant Bacterial Isolates: Hemagglutination and Hemolytic Activities against Human Erythrocytes

The classification of bacteria as multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) are epidemiologically significant for the assessment of bacterial resistance to antibiotics in geographical regions. This study determined the occurrence of MDR-, XDR-, and PDR-bacteria in clinical samples using the standard protocol, disc diffusion method, and VITEK 2 automated system, and evaluated the hemolytic and hemagglutination activities of the bacterial isolates using blood agar and human erythrocyte suspensions of known blood groups A, B, and O (Rhesus +) washed with phosphate buffer saline. Of the 314 isolates from urine, 9.6 and 4.1% were XDR and PDR, respectively. Isolates from the wound and blood were highly resistant to amoxicillin and tetracycline; E. faecalis from the stool was highly resistant to amoxicillin and tetracycline, while P. aeruginosa showed a low resistance to streptomycin and aztreonam. Hemagglutination activities against blood groups A⁺, B⁺, AB⁺, and O⁺ were positive in 67.2, 51.6, 56.1, and 44.9% of urine isolates, respectively; 57.4% of MDR isolates from wounds agglutinated blood A⁺ group cells, 48.9% agglutinated blood AB⁺ group cells, and 40% agglutinated blood O⁺. Of the 187 blood isolates, 58.8, 40.6, 48.1, and 39% were positive for hemagglutination activities against blood groups A⁺, B⁺, AB⁺, and O⁺, respectively; 45% of the isolates from stools hemolyzed blood group A⁺ cells, while < 40% of the isolates hemolyzed blood group B⁺, AB⁺, and O⁺ cells. This study has shown the significance of using appropriate human RBCs when studying the hemagglutination and hemolytic activity of pathogenic bacterial isolates.