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Increasing ciprofloxacine resistance in the bacteria isolated from urine samples: 1999–2004

Abstract number: 1733_630

Acikgoz Z., Gocer S., Gamberzade S., Karahocagil M., Alici O.

Purpose: The aim of the study was to determine the ciprofloxacin resistance of various bacterial species responsible for UTIs according to IDSA guidelines for UTIs between 1999 and 2004, retrospectively.

Materials and Methods: Overall 3,520 unduplicated urinary isolates were screened for their ciprofloxacin resistance between 1999 and 2004, retrospectively. Of the isolates 3,276 (93.1%) were from outpatients and 244 (6.9%) from the hospitalised ones. The screening was made regardless of age, gender and other demographic parameters. The isolates were identified by using conventional biochemical tests and the semi automated API systems (bioMérieux, France) when it was required. Antimicrobial susceptibility assays were performed using the disc diffusion method according to the recommendations of Clinical and Laboratory Standards Institute (CLSI) criteria. The data were analysed by Chi-square test in SPSS 10.0 programme and p values lower than 0.05 were considered significant.

Results: Of the screened isolates 3,216 (91.4%) were Gram negative bacilli and 304 (8.6%) were Gram positive cocci. Totally 29.9% (73/244) of in-patients isolates and 11.8% (281/2,376) of outpatient isolates had ciprofloxacin resistance. Out-patient and in-patient distributions of the resistant isolates according to main microorganism groups were as follows: For Gram positives 34.7% (n.8) and 65.3% (n.15); for Gram negatives 19.6% (n.65) and 80.4% (n.266), respectively. While there was no statistically significant difference between Gram positive and Gram negative microorganisms in terms of ciprofloxacin resistance (p > .05), the resistance rates of isolates from in-patients and out-patients differed significantly (p < 0.001). Ciprofloxacin resistance rates over the six years (1999–2004) were: 3.3% (17/509), 4.2 (33/551), 6.7 (40/593), 13% (102/786), 16.1% (124/768) and 15.3% (48/313) respectively. the differences between 1999 and 2001, 1999 and 2002, 2000 and 2001, 2000 and 2002 and 2001 and 2002 were significant (p < 0.05).

Table 1. Distribution of bacterial species and their ciprofloxacin resistance rates

SpeciesNo. of isolatesResistance
n(%)   
E. coli2,44430512.5
Klebsiella spp.480214.4
Proteus spp.190
Enterococcus spp.1371813.1
Gr. B streptococci8511.1
Staphylococcus spp.a8244.9
Enterobacter spp.51
Pseudomonas spp.5159.8
Total3,52035410.1
aIncluding Staphylococcus aureus and coagulase-negative staphylococci.

Conclusions: We concluded that a prominent increase in ciprofloxacin resistance has emerged in bacteria isolated as UTI agents, especially in E. coli. This problem of resistance is a considerable issue for in-patients and has the potential to affect out-patients in long term periods.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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