QUINOLONE-RESISTANT ISOLATES OF ENTEROBACTERIACEAE FROM COMMUNITY-ACQUIRED URINARY TRACT INFECTIONS

Maria Carolina Albuquerque Wanderley (UPE); Thammy Moura Samico (UPE); Anna Carolina Soares Almeida (UPE); Felipe Lira de Sá Cavalcanti (UPE); Marinalda Anselmo Vilela (UPE); Marcia Maria Camargo de Morais (UPE)

Fluoroquinolones have been used for treatment of urinary tract infections (UTI) successfully. These antimicrobials inhibit the enzyme DNA gyrase in gram negative bacteria and Topoisomerase IV in gram positive bacteria. Resistance to fluoroquinolones occurs mainly as a result of mutations in bacterial gyrA and parC genes that code for DNA gyrase and topoisomerase IV, respectively. However, it was recently described a new resistance mechanism, which is provided by qnr gene. The aim this work was to identify quinolone-resistant urine isolates in Enterobacteriaceae from community, to characterize their susceptibility profiles and to investigate the presence of ESBL-mediated  b-lactam resistance. A total of 24 samples were obtained from community-acquired UTIs. Results showed that the isolated bacteria were Escherichia coli (83%) and Klebsiella spp. (17%). Antimicrobial activities of ciprofloxacin (CIP), cefotaxime (CTX) and sultamethazole-trimethoprim (SUT) were determined by disk diffusion method, according to the Clinical Laboratory Standards Institute (CLSI) guidelines. All the samples were observed as resistant to ciprofloxacin. Resistance to SUT was 75%, while resistance to CTX and GEN were 25% and 38%, respectively. The quinolone resistance was also accompanied by ESBL production in 17% of the isolates. When taken separately, only 5% of E. Coli isolates showed ESBL production, in contrast to 60% of Klebsiella spp. isolates. These findings support the suggestion that antibiotic resistance mechanisms are spreading more easily in bacteria causing community-acquired UTIs. The detection of Enterobacteriaceae´s samples with quinolone-resistant configures an emerging problem on public health, with importante implications in the antimicrobial therapeutic. In order to reduce the frequency of multiple-antibiotic resistant bacteria, epidemiologic surveillance and the rational use of antibiotic protocols need to be stablished.