In vitro Susceptibility Analysis of Escherichia coli Strains Isolated from Urinary Tract Infections to Fosfomycin, Nitrofurantoin and Ciprofloxacin

Abstract

Introduction: Escherichia coli is the most commonly isolated microorganism from uncomplicated lower urinary tract infections (UTI). The occurrence of high ciprofloxacin resistance and production of extended spectrum beta-lactamase (ESBL) in E. coli isolates have led the researchers to investigate new treatment approaches. Materials and Methods: A total of 366 E. coli strains isolated from urine samples of patients with the diagnosis of UTI, who were referred to our laboratory from different departments at our hospital, were included in this study. Results: Ninety (24.6%) isolates were found to be ESBL-positive and 276 (75.4%) were ESBL-negative. The rates of susceptibility to fosfomycin, nitrofurantoin and ciprofloxacin in ESBL-positive and ESBL-negative E. coli strains were found to be 100% and 99.7%, 80% and 90.6%, and 40% and 80.8%, respectively. Conclusion: In conclusion, ciprofloxacin resistance was high and resistance to fosfomycin and nitrofurantoin was very low in E. coli. Therefore, we assume that fosfomycin and nitrofurantoin can be used as empiric therapy for uncomplicated UTI caused by E. coli.

Keywords

• Urinary tract infection
• extended spectrum beta lactamase
• Escherichia coli
• fosfomycin
• nitrofurantoin
• ciprofloxacin