Investigation of Antibiotic Susceptibility Profiles of Escherichia coli Strains Grown in Urine Cultures

Year 2025, Volume: 11 Issue: 3, 151 - 159, 30.08.2025

Hacer Özlem Kalaycı , Mustafa Kerem Çalgın , Yunus Emre İbik

Abstract

Objective: Escherichia coli (E. coli) is the most commonly isolated agent in urinary tract infections, and since antibiogram test results take a long time, empirical antibiotics are usually chosen when starting treatment. Since antibiotic susceptibilities show geographical differences, regional susceptibility results should be known. The aim of this study was to retrospectively determine the antibiotic susceptibilities of E. coli strains isolated from urine cultures between April 2021 and April 2024 in the Microbiology laboratory of Ordu University Medical Faculty Hospital.
Method: Urine samples were processed in the laboratory according to routine microbiological standards and examined with the BD Phoenix M50 automated bacterial identification and antibiotic susceptibility testing systems.
Results: During the study period, 38151 urine samples were sent to the laboratory and E. coli growth was detected in 4241 (31.7%) of them. The most sensitive antibiotics in E. coli were nitrofurantoin (2.8%), fosfomycin (4.3%), imipenem (4.4%) and amikacin (4.5%), while the most resistant antibiotics were ampicillin (60.4%), ceftazidime (36. 2%), levofloxacin (36.1%), trimethoprim/sulfamethoxazole (TMP-SXT) (35.1%), ciprofloxacin (32.1%) and amoxicillin-clavulanic acid (AMC) (31.5%). In addition, resistance rates have changed over the years.
Conclusion: As a result of increasing antibiotic resistance, treatment of urinary tract infections becomes more difficult. For this reason, determining regional antibiotic resistance profiles will help to ensure success in treatment by selecting appropriate antibiotics and to prevent unnecessary use of antibiotics.

Keywords

Antibiotic resistance , E.coli , urinary tract infection , fosfomycin

References

• Kaye KS, Gupta V, Mulgirigama A, Joshi AV, Scangarella-Oman NE, Yu K, et al. Antimicrobial resistance trends in urine Escherichia coli isolates from adult and adolescent females in the United States from 2011 to 2019: rising ESBL strains and impact on patient management. Clin Infect Dis. 2021;73(11):1992-9.
• Forbes BA, Sahm DF, Weissfeld AS. Diagnostic microbiology. s.288-302, St Louis: Mosby (2007).
• Budak S, Utku S, Aksoy EE, Karakeçe E, Aydemir H, Budak GG, et al. Investigating the distribution of the bacteria that lead to urinary tract infections and antibiotic susceptibility of E. coli. New J Urol. 2015;10(1):21-4.
• Sierra-Díaz E, Hernández-Ríos CJ, Bravo-Cuellar A. Antibiotic resistance: Microbiological profile of urinary tract infections in Mexico. Cir Cir. 2019;87(2):176-82.
• Temoçin F, Köse H. Evaluation of Extended Spectrum Beta-lactamase Production Rates and Antibiotic Susceptibilities of Escherichia coli and Klebsiella pneumoniae Strains Isolated from Urine Cultures of Outpatients. ANKEM Derg. 2018;32(3):79-86.
• McLellan LK, Hunstad DA. Urinary tract infection: pathogenesis and outlook. Trends Mol Med. 2016;22(11):946-57.
• Çalgın MK, Çetinkol Y, Erdil A. Antibiotic resistance rates and bacteria isolated from urine samples of pediatric patients in Ordu. Bozok Med J. 2017;7(1):64-9.
• Tuna A, Arslan F, Akkuş I, Böke E, Şahin O, Kaçmaz B, et al. Investigation of resistance rates of Escherichia coli strains isolated from urine cultures to antibiotics frequently used in clinics. Kırıkkale University Med J. 2024;26(1):1-4.
• Sucu N, Aktoz-Boz G, Bayraktar O, Çaylan R, Aydın K, Köksal İ. The change of antibiotic susceptibilities of uropathogen Escherichia coli strains in years. Klimik Journal. 2004;17(2):128-31.
• Jadoon SA, Ahmed A, Irshad R. Spectrum of bacterial culture and drug sensitivity vs resistance in uncomplicated urinary tract infection. J Ayub Med Coll Abbottabad. 2018;30(3):432-8.
• Keskin BH, Çalışkan E, Kaya S, Köse E, Şahin I. Bacteria that cause urinary system infections and antibiotic resistance rates. Journal of Turkish Society of Microbiology. 2021;51(3):254-62.
• Çakır A, Acar H. Comparison of empiricular antibiotic and culture antibiogram sensitivity for urinary tract infection in emergency department. Turk J Clin Lab. 2023;14(2):285-93.
• Çaycı YT, Karacan G, Yoosefi M, Bilgin K, Vural DG, Birinci A. Retrospective evaluation of gram-negative bacteria and their antibiotic susceptibility isolated from urine cultures in children. Ahi Evran Med J. 2021;6(2):168-73.
• Duran H, Çeken N, Atik TK. Antibiotic resistance rates of Escherichia coli and Klebsiella pneumoniae strains isolated from urine culture: A four-year analysis. ANKEM Derg. 2020; 34(2):41-7.
• Kengne M, Dounia AT, Nwobegahay JM. Bacteriological profile and antimicrobial susceptibility patterns of urine culture isolates from patients in Ndjamena, Chad. Pan Afr Med J. 2017;28(1).
• Samancı Aktar G, Ayaydın Z, Rahmanalı Onur A, Gür Vural D, Temiz H. Resistance rates against various antimicrobials in Escherichia coli strains isolated from urine samples. Kocaeli Med J. 2018;7(1):8-13.
• Avcıoğlu F, Behçet M. Evaluation of resistance rates of Escherichia coli isolates of urinary tract infection to various antibiotics. Journal of Turkish Society of Microbiology. 2020;50(3):172-7.
• Gündüz A, Mansur A. Antimicrobial resistance rates in Escherichia coli strains isolated in urine cultures of outpatients: five years analysis. Turk Bull of Hyg and Exp Bio. 2023;80(1):23-32.
• Teker B, Sever N, Garashova D. The effect of age and gender on antibiotic resistance of Escherichia coli isolates of urinary tract infection. Online Turk J Health Sci. 2021;6(2):300-9.
• Aydemir O, Terzi HA, Köroğlu M, Altındiş M. Piperacillin / tazobactam in-vitro activity in Escherichia coli and Klebsiella pneumoniae strains with extended spectrum beta-lactamase production. Online Turk J Health Sci. 2019;4(2):118-27.
• Mancuso G, Midiri A, Gerace E, Marra M, Zummo S, Biondo C. Urinary tract infections: the current scenario and future prospects. Pathogens. 2023;12(4):623.
• Yüksek G, Memiş N, Öksüz S. Antibiotic susceptibility of Escherichia coli strains isolated from urine samples. J DU Health Sci Inst. 2021;11(2):137-42.
• Gupta K. Acute simple cystitis in females. UpToDate Post TW Ed UpToDate Waltham MA. 2023.
• Gupta K, Hooton TM, Naber KG, Wullt B, Colgan R, Miller LG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011;52(5):e103-20.
• Mert D, Çeken S, Ertek M. The isolated bacteria from culture and antibiotic susceptibilities in urinary tract infections. Turk Bull of Hyg and Exp Bio. 2020;77(1):25-32.
• Aşgın N, Çakmaklıoğulları EK. In-vitro antibiotic resistance profile of E. coli strains isolated from community-acquired paediatric urinary tract infections in Karabük province. J Contemp Med. 2017;7(3):241-5.
• Kömürlüoğlu A, Aykaç K, Özsürekçi Y, Başaranoğlu ST, Bıçakçıgil A, Liste Ü, et al. Antibiotic resistance distribution of gram-negative urinary tract infectious agents: single center experience. Turkish J Pediatr Dis. 2018;12(1).
• Avcıküçük H, Altın N. Evaluation of the distribution and antibiotic resistance profile of strains isolated from urine specimens. Klimik Journal. 2022;35(2):95-102.
• Çilburunoğlu M, Kirişci O, Yerlikaya H, Uğurlu H, Aral M, Muratdağı G. The evaluation of the distribution and antimicrobial susceptibility profile of strains isolated from urine specimens at a university hospital. Sakarya Med J. 2020;10(4):677-83.
• Kalyoncu BN, Koçoğlu E, Özekinci T, Biçer RT, Aydın G, Önder N, et al. Evaluation of urinary system pathogens and their antibiotic resistance profiles isolated in a city hospital in Istanbul. ANKEM Derg. 2023;37(1):18-27.