Naslov
Forgotten old antibiotic: effectiveness of nitroxoline in the treatment of urinary tract infections caused by quinolone-resistant Escherichia coli

Autori
Pavišić, Antea Doris ; Barišić, Zvonimir

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, ostalo

Izvornik
ESCMID eLibrary / - : ESCMID, 2019

Skup
29th ECCMID

Mjesto i datum
Amsterdam, Nizozemska, 13.04.2019. - 16.04.2019

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
nitroxoline, urinary tract infections, quinolone resistant E. coli

Sažetak
Background: Urinary tract infections (UTIs) caused by quinolone resistant E. coli are becoming more common in the last decade. Those infections are difficult to treat and therapeutic options are limited. The objective of this research was to determine susceptibility of quinolone resistant strains of E. coli from urine samples of outpatients to forgotten old urinary antibacterial agent – nitroxoline. Nitroxoline has been used for the treatment of UTIs for more than 50 years, but not as antibiotic of the first choice. Materials and Methods: In this retrospective study during a 2-month-period in 2018, 146 non duplicated isolates of quinolone resistant E. coli were collected from routine urine cultures of outpatients. Among 146 isolates, 42 isolates were extended-spectrum beta-lactamases - producing (ESBL) E.coli. Selection criteria was resistance to quinolones: ciprofloxacin and norfloxacin. In vitro antibiotic susceptibility to ciprofloxacin and norfloxacin as well as nitroxoline was tested by agar disk diffusion method. The 30-µg nitroxoline disk was used. Results were interpreted according to EUCAST breakpoints. Disk diffusion method was also used to detect ESBL producing E. coli, also according to EUCAST rules. Results: Applying the above-mentioned breakpoints, 142 of 146 isolates had inhibition diameter ≥15 mm and were rated as susceptible to nitroxoline according to EUCAST breakpoints. Only 4 isolates had inhibition zone 14 mm and less and were resistant to nitroxoline. All 42 ESBL producing E. coli isolates were susceptible to nitroxoline. Nitroxoline showed 97.26 % in vitro activity against urine isolates of E. coli and 100% activity against ESBL producing isolates of E. coli. Conclusion: Incidence of quinolone resistant E.coli in urine cultures is increasing in Croatia as well as worldwide. Such isolates are usually multidrug resistant and often ESBL producing. Because of increasing resistance, quinolones cannot be the first line antibiotics for the treatment of UTIs, so nitroxoline should be reconsidered as antibiotic of the first choice. It showed very low resistance to quinolone resistant and ESBL producing isolates of E.coli so is effective and good alternative for UTIs caused by this kind of microorganisms.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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