High prevalence of fluoroquinolone-resistant Escherichia coli strains isolated from urine clinical samples

Dehbanipour, Razieh; Khanahmad, Hossein; Sedighi, Mansour; Bialvaei, Abed Zahedi; Faghri, Jamshid

doi:10.15167/2421-4248/jpmh2019.60.1.884

Cited by 1 publication

(1 citation statement)

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“…Resistance is commonly due to mutations in drug targets, though upregulated efflux pumps, protection of target structures and reduced permeability of the outer membrane are all thought to play a role in resistance ( Figure 1 ) [ 46 ]. A 2016 study from the US found that 28.2% of tested strains were resistant to fluoroquinolones, while a 2019 study in Iran found 45.2% of their isolates were fluoroquinolone resistant [ 49 , 50 ]. Though fluoroquinolones are not a first-line treatment in UTI cases, reports show their prescription in nearly 50% of uncomplicated UTI cases [ 51 ].…”

Section: Multi-drug Resistance In Upecmentioning

confidence: 99%

Current and Emerging Treatment Options for Multidrug Resistant Escherichia coli Urosepsis: A Review

Walker

Roberts²,

Rogers³

et al. 2022

Antibiotics

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Escherichia coli is a versatile commensal and pathogenic member of the human microflora. As the primary causative pathogen in urosepsis, E. coli places an immense burden on healthcare systems worldwide. To further exacerbate the issue, multi drug resistance (MDR) has spread rapidly through E. coli populations, making infections more troublesome and costlier to treat. This paper aimed to review the literature concerning the development of MDR in uropathogenic E. coli (UPEC) and explore the existing evidence of current and emerging treatment strategies. While some MDR strains maybe treated with β-lactam-β-lactamase inhibitor combinations as well as cephalosporins, cephamycin, temocillin and fosfomycin, current treatment strategies for many MDR UPEC strains are reliant on carbapenems. Carbapenem overreliance may contribute to the alarming dissemination of carbapenem-resistance amongst some UPEC communities, which has ushered in a new age of difficult to treat infections. Alternative treatment options for carbapenem resistant UPEC may include novel β-lactam-β-lactamase or carbapenemase inhibitor combinations, cefiderocol, polymyxins, tigecycline, aminoglycosides or fosfomycin. For metallo-β-lactamase producing strains (e.g., NDM, IMP-4), combinations of cefazidime-avibacam with aztreonam have been used. Additionally, the emergence of new antimicrobials brings new hope to the treatment of such infections. However, continued research is required to successfully bring these into the clinic for the treatment of MDR E. coli urosepsis.

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