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Fluoroquinolone resistance in Enterobacteriaceae strains isolated from community-acquired urinary tract infections

Abstract number: R2419

Skandami-Epitropaki V., Xanthaki A., Tsiringa A., Fotiou P., Kontou CHA., Toutouza M.

Objectives: Community-acquired urinary tract infections (UTI) are among the most common bacterial infections in Greece. After quinolones became the first choice for empirical therapy of UTIs, their subsequent overuse resulted to increasing quinolone resistance among uropathogens. Aim of this study is to investigate the frequency and antibiotic susceptibility of quinolone resistant bacterial stains isolated from patients with community-aquired bacteriuria and compare it with urinary pathogens from hospitalised patients.

Methods: During a 3-years period (2005–2007) a total of 1703 bactrial strains were isolated from urine samples submitted for culture in our hospital laboratory from the community (632) and from hospitalised patients (1071) with UTI. Cultures and bacterial identification were obtained by conventional methods. The sensitivity to antibiotics was tested by Kirby-Bauer disk diffusion method according CLSI criteria.

Results: Of the 1703 bacterial strains studied (Escherichia coli 1372, Klebsiella pneumoniae 197, Proteus mirabilis 134), 15.6% were found to be quinolone resistant. Quinolone resistance for all Enterobacteriaceae was 21.1% for hospitalised patients (HP) and 6.2% for community patients (CP). Quinolone resistance for E. coli was 17.4% for HP and 5.05% for CP, for K. pneumoniae 38.1% for HP and 18.9% for CP and for P. mirabilis 24.7% for HP, 9.7% for CP. Susceptibility percentage of the 1703 quinolone resistant isolates to other antimicrobial agents was for HP and CP respectively as following: For E. coli ampicillin (AM) 7.1–10.7%, amoxicillin-clavulanate (AMC) 49.3%-53.6%, piperacillin-tazobactam (TZP) 75.4%-85.7%, cefuroxime (CXM) 61.3%-82.1%, sulfamethoxazole-trimethoprim (SXT) 19%-17.9%, ceftazidime (CAZ) 71.1%-82.1%, cefepime (FEP) 73.2%-85.7%, gentamicin (GM) 76.6%-71.4%. For K. pneumoniae AM 0%-0%, AMC 16.4%-14.3%, TZP 19.7%-28.6%, CXM 14.8%-42.9%, SXT 1.6%-0%, CAZ 18%-42.9%, FEP 26.2%-42.9%, GM 65.6%-85.7%. For P. mirabilis AM 0%-0%, AMC 13%-0%, TZP 91.3%-100%, CXM 8.7%-0%, SXT 0%-0%, CAZ 13%-0%, FEP 95.7%-100%, GM 30.4%-25%.

Conclusions: High resistance rates to fluoroquinolones were observed in uropathogen bacteria isolated not only from hospitalised patients but also in bacteria associated with community-acquired urinary tract infections in Greece. Strict antibiotic policy concerning UTI in community patients, is needed.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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