Antimicrobial resistance of 615 Escherichia coli isolated from complicated and non-complicated urinary tract infections

Abstract

Objective: Escherichia coli strains are the most common pathogens of urinary tract infections (UTI) and are capable of producing "extended spectrum beta-lactamases" (ESBL). Since high ciprofloxacin resistance has been emerging recently among E.coli strains, this study is aimed to investigate ESBL production and antibiotic resistance pattern including ciprofloxacin, in 615 E.coli strains isolated from complicated and uncomplicated UTIs and differences between two groups. Material and Methods: The antimicrobial susceptibility testing for ciprofloxacin, trimethoprim-sulfamethoxazole, amoxicilline-clavulanate, amikacin, piperacil- line-tazobactam and imipenem/meropenem was performed using Kirby-Bauer disc diffusion method according to Clinical and Laboratory Standards Institute (CLSI) rules. ESBL presence was investigated with double disc diffusion method. Antibiotic susceptibilities of complicated and uncomplicated group with UTI were compared statistically using Fisher's chi square test. Results: E.coli strains were isolated from 333 of 2458 patients with uncomplicated UTI and 282 of 2098 patients with complicated UTI. ESBL presence was in 13% and 20%, and ciprofloxacin resistance was 38% and 46% in uncomplicated and complicated groups, respectively. ESBL presence in ciprofloxacin resistance strains was 25% in uncomplicated group and 40% in complicated group. ESBL ratio in ciprofloxacin-susceptible strains was 4% in both groups. Statistically, ESBL production in ciprofloxacin resistance strains was higher in the complicated group (p< 0.05). Conclusion: Antibiotic resistance in pathogens which are responsible from UTIs is emerging worldwide. We found that ESBL production in ciprofloxacin resistant E.coli strains was significantly higher in the complicated group. This may result from misuse and injudicious use of antimicrobials, especially ciprofloxacin. Nowadays, ESBL producing multidrug resistant E.coli strains are in community as a new challenge emerged for clinicians to overcome. © 2011 by Türkiye Klinikleri.