Evolution of Resistance to Fluoroquinolones of Uropathogenic Strains of Escherichia coli Isolated at the University Hospital of Marrakesh, Morocco

Abstract

Background: Urinary tract infection is a common pathology in practice. The most implicated bacterial species is Escherichia coli. Fluoroquinolones occupy a privileged place among the molecules most prescribed in the treatment of these infections. Objective: determine the fluoroquinolone resistance profile of uropathogenic Escherichia coli strains at University Hospital Med VI of Marrakesh and analyze the evolution of this resistance over time in these isolates. Materials and methods: Descriptive study, over a period of 5 years (January 1, 2013 - December 31, 2017), covering all uropathogenic strains of E.coli isolated from outpatients and hospitalized at the University Hospital of Marrakesh. The samples were processed and analyzed in the Microbiology laboratory of the University Hospital. Results: During the study period, 1411 strains of uropathogenic E.coli were included. Women were mostly affected (68%). The prevalence of urinary tract infection was 22%. The number of strains studied and the resistance rates were calculated by combining the resistant strains and the intermediate strains. Resistance to ciprofloxacin increased from 16% in 2013 to 32% in 2017. An increase with age has been demonstrated for resistance to fluoroquinolones. Extended spectrum beta-lactamase production significantly affected the resistance rate to fluoroquinolones in E.coli (24% in C3G-sensitive strains and 56% in ESBL strains). Conclusion: This study demonstrates the serious emergence of the resistance of uropathogenic E.coli strains to fluoroquinolones, hence the interest of revising the empirical treatment of urinary tract infections in our country and monitoring use antibiotics to control the diffusion of quinolone resistance in E.coli.