Increasing ciprofloxacin resistance among prevalent urinary tract bacterial isolates in Bangladesh.

Abstract

Ciprofloxacin was evaluated along with other commonly used antibiotics against a total of 425 clinical isolates obtained from urine samples. Samples were collected from outdoor patients from different parts of Dhaka city. Susceptibility tests were done by the standardized disk diffusion method. Among the tested drugs, the percent susceptible rates observed were: ciprofloxacin (74%), ampicillin (29%), cephalexin (54%) and trimethoprim-sulfamethoxazole (43%) tested against all organisms; gentamicin (73%) tested against gram-negative organisms and erythromycin (72%) tested against gram-positive organisms. Ciprofloxacin showed better activity against gram-negative isolates (80%) compared to the other antibiotics. However, strains highly resistant to ciprofloxacin were detected among commonly isolated gram-negative urinary pathogens: Escherichia coli (18%), Klebsiella species (19%) and Pseudomonas species (30%). Overall susceptibility rate for gram-positive cocci was significantly low for all the antibiotics tested including ciprofloxacin (62%). Minimal inhibitory concentration (MIC) of ciprofloxacin was measured for all resistant and susceptible urinary tract infection (UTI) isolates. This study indicates emerging ciprofloxacin resistance among most UTI bacterial pathogens. Increasing resistance against ciprofloxacin demands coordinated monitoring of its activity, and rationale use of the antibiotic in UTI.