Prevalence and antibiotic susceptibility pattern of quinolones and cephalosporins resistant uropathogenic Escherichia coli in the north Iran

Escherichia coli is a Gram-negative bacillus of the Enterobacterales order that is considered an opportunistic pathogen. One of the places they can enter is the urinary tract, which is called the Uropathogenic E. coli (UPEC) strains and the infections that result from it are called urinary tract infection (UTI). The aims of this study was to obtain new information about the antibiotic susceptibility pattern of quinolones and cephalosporins resistant E. coli. In this retrospective cross-sectional study, all cases of urinary tract infections caused by E. coli isolates referred to Razi Hospital in Rasht, the North of Iran over a period of three years were evaluated. Antimicrobial susceptibility patterns were evaluated using disk diffusion method. The total number of E. coli bacteria isolated from urine samples of patients with UTIs from ۲۰۱۶ to ۲۰۱۸ was ۱۲۲۴ cases. Totally, ۳۸۲ out of ۶۱۲ tested E. coli isolates were ciprofloxacin resistant (۶۲.۴%). While, ۲۵۱ out of ۴۴۶ tested E. coli isolates were cephalosporins (۵۶.۳%). Among the tested isolated, ۲۰۶ cases were resistant to both antibiotics (cephalosporin and ciprofloxacin), of which ۷۱ (۳۴.۵%) were recovered from male and ۱۳۵ (۶۵.۵%) from female samples. The highest antibiotic susceptibility to E. coli was related to amikacin (۷۴.۸%) and followed by nitrofurantoin (۶۷.۵%). The results showed an alarming rate of cephalosporin and ciprofloxacin resistance among E. coli causing UTI in our region. These findings suggest optimizing local stewardship programs and infection control policy.