CiproWoxacin-resistant uropathogenic Escherichia coli: study of beta-lactam susceptibility proXle and ESBL-mediated resistance

Abstract

Urinary tract infections (UTIs) are frequent in the population and are mainly caused by species of the Enterobacterial order, such as Escherichia coli. Quinolones are widely used in empirical treatment, but the report of therapeutic failure due to bacterial resistance to this class of antimicrobials has been striking, with other classes being instituted for the treatment of these UTIs, such as beta-lactams. Consequently, resistance to this class has increased, with inactivation by betalactamase enzymes being the main cause, with great emphasis on the Extended Spectrum Betalactamase Enzymes (ESBL) and carbapenemases. Thus, this study aimed to evaluate the susceptibility prole of ciprooxacinresistant uropathogenic E.coli to the main beta-lactams used in the clinic, as well as to investigate the presence of ESBL enzymes among these isolates. The β-lactam susceptibility prole by the agar diusion technique and the phenotypic investigation by the disk approximation method of ESBL production were performed according to the Clinical Laboratory Standards Institute (CLSI, 2019) in 52 isolates of ciprooxacin-resistant E.coli. 32.7% (17/52) of the isolates were sensitive and 30.8% (16/52) intermediate to the beta-lactams tested. Furthermore, 11.5% (6/52) were resistant to carbapenems and ESBL production was detected in 22 isolates (42.3%). These ndings reveal the importance of investigating the context of the susceptibility of ciprooxacin-resistant E. coli and highlight the need for constant review of UTI treatment protocols and monitoring of the spread of bacterial resistance to these clinically relevant compounds.