Assessment of Gut Bacteria Profile and Antibiotic Resistance Pattern Among Psychotropic Drug Users: Comparative Cross-Sectional Study.

ABSTRACT

INTRODUCTION: In the twenty-first century, antibiotic resistance is becoming one of the major global public health threats. Several complex factors are associated with the emergence and spread of antibiotic resistance. Emerging evidences are indicating that drugs used for chronic illness conditions might have a contribution for antibiotic resistance either through drug-drug interactions or metabolism of the drugs by gut microbiota. OBJECTIVE: The aim of this study was to compare the bacteria profile and resistance patterns of gut bacteria isolated from participants using psychotropic drugs and apparently healthy controls. METHODS: Socio-demographic data were collected from patients using psychotropic medications and apparently healthy persons. Clinical data were collected from patient records. Stool samples were collected from 107 patients using psychotropic medications and 107 apparently healthy controls. Gut bacterial flora were isolated and identified using oxidase, indole, and BD BBL crystal Enteric/Non-fermenter identification system. Antibiotic susceptibility test was done using the disk diffusion method, and Mast disks were used to identify extended-spectrum betalactamase (ESBL) and/or AmpC-producing isolates. RESULTS: A total of 245 bacterial isolates were isolated and identified. From these, 124 (50.6%) bacteria were isolated from patients using Psychotropic medications. There was no bacteria profile difference between the two groups. Escherichia coli was the prevalent [100 (80.6%) and 102 (84.3%)] bacteria isolated from patients using psychotropic medications and apparently healthy controls, respectively. Escherichia coli isolated from patients using psychotropic medications showed significantly higher resistance against amoxicillin-clavulanic acid, cephalosporin (2nd, 3rd, 4th generations), meropenem, ciprofloxacin and tetracycline. The odds of isolating ESBL-producing Enterobacteriaceae [(OR=2.3, 95% C.I (1.4-4.0)] and MDR [OR=5.4, 95% C.I (1.5-29.8)] were higher on patients using psychotropic medications. CONCLUSION: The observed antibiotic resistance pattern of bacteria isolated from guts of patients using psychotropic medications was very high. The magnitude of antibiotic resistance is more pronounced among E. coli isolates.