Trimethoprim-Sulfamethoxazole and Ciprofloxacin Resistance Rates in Escherichia coli and Klebsiella spp. in Urinary Tract Infections: A 10-Year Evaluation

Abstract

Objective: Urinary tract infections are the most common bacterial infections among community-acquired infections in all age groups. In this study, we aimed to evaluate the distribution of Escherichia coli and Klebsiella spp. in community-acquired urinary tract infections by years and the resistance rates to trimethoprim-sulfamethoxazole (TMP-SXT) and ciprofloxacin antibiotics, which are used as the first choice in community-acquired urinary tract infections. Methods: All urine culture samples from all age groups admitted to the medical microbiology laboratory from outpatient clinics and emergency services between January 2011 and August 2021 were retrospectively analyzed. Samples with E. coli and Klebsiella spp. detected as causative agents in urine cultures were included in the study. Conventional methods and automated systems were used to identify bacteria and for antibiotic susceptibility tests. Results: E. coli (n=50 430) and Klebsiella spp. (n=7763) isolated from urine cultures between January 2011 and August 2021 were evaluated. The lowest and highest resistance rates for ciprofloxacin and TMP-SXT for E. coli were 25-40% and 35-51%, respectively. Ciprofloxacin and TMP-SXT resistance rates for Klebsiella spp. were the lowest and highest at 17-43% and 31-43%, respectively. Conclusion: Knowing the resistance rates of antibiotics used as the first choice against common agents such as E. coli and Klebsiella spp. in treating community-acquired urinary tract infections may guide the empirical antimicrobial therapy.