Evaluation of ciprofloxacin and imipenem resistance among uropathogenic bacterial strains using the disk diffusion and E-test methods in Shahid-Beheshti Hospital in Kashan during 2012-2013

An increasing occurrence of antimicrobial resistance among uropathogenic bacterial isolates has complicated the treatment process. The aim of this study was to evaluate the ciprofloxacin and imipenem resistance among uropathogenic bacterial strains isolated from patients with urinary tract infection (UTI). This cross-sectional study was conducted in Kashan from December 2012 to June 2013. A total of 391 urine samples were collected from patients with UTI and identified by standard biochemical tests. Antimicrobial susceptibility pattern screening was determined using the disk diffusion method. The minimum inhibitory concentrations (MICs) of Escherichia coli, Klebsiella spp isolates that were resistant to ciprofloxacin and imipenem by disk diffusion were determined using the E-test method. Among 391 positive urine cultures, 72.1% were from females and 27.9% from males. Escherichia coli were identified as the most prevalent uropathogenic bacteria. Resistance to ciprofloxacin among E. coli, Klebsiella spp, Enterococcus spp and Acinetobacter baumannii isolates were 37.8%, 22.5%, 36.8% and 62.5%, respectively. Resistance to imipenem was not found in any isolate. We found that all ciprofloxacin resistant E. coli and most (94%) of the ciprofloxacin resistant Klebsiella isolates had ciprofloxacin MICs in the resistance level by the E-test method. Ciprofloxacin resistance among prevalent uropathogenic bacterial isolates is increasing. However, imipenem is still effective against these bacterial infections and needs to be saved to maintain the effectiveness.