title: High prevalence of multidrug-resistance uropathogenic Escherichia coli strains, Isfahan, Iran.
abstract: OBJECTIVE
  Urinary tract infection (UTI) is one of the most frequent infectious diseases and can occur in all age groups. Escherichia coli is the main cause of this infection. Multiple resistances to antimicrobial agents are increasing quickly in E. coli isolates and may complicate therapeutic strategies for UTI. The aim of this study was to determine the antibiotic resistance pattern and the multidrug-resistance (MDR) phenotypes in uropathogenic E. coli (UPEC).
  
  
  METHODS
  A total of 135 UPEC isolates were collected from both outpatients (91 isolates) and inpatients (44 isolates) between September, 2012 and February, 2013. In order to determine the MDR among UPEC isolates, we have tested 15 antimicrobial agents and antibiotic susceptibility was done by Kirby-Bauer disk diffusion method.
  
  
  RESULTS
  The percentage of MDR isolates (resistant to at least three drug classes such as aminoglycosides, fluoroquinolones, penicillins, cephalosporins, or carbapenems) was 68% in the inpatients and 61% in the outpatients. Antibiotic resistance to ampicillin, ceftazidim, nalidixic acid, and trimethoprim/sulfamethoxazole were higher than 50%. Amikacin, nitrofurantoin, and gentamicin showed markedly greater activity (89.1%, 85.9%, and 82.4% sensitivity, respectively) than other antimicrobial agents. Resistance to meropenem did show either in outpatients or in inpatients.
  
  
  CONCLUSIONS
  The high prevalence of drug resistance among UTI patients calls for continuous monitoring of the incidence of drug resistance for appropriate empiric selection of antibiotic therapy. Empirical treatment of UTIs should be relied on susceptibility patterns from local studies.
authors.affiliation: Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Razieh
authors.initials: R
authors.lastname: Dehbanipour
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Tehran, Iran.
authors.forename: Sedighe
authors.initials: S
authors.lastname: Rastaghi
authors.affiliation: Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mansour
authors.initials: M
authors.lastname: Sedighi
authors.affiliation: Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Nafiseh
authors.initials: N
authors.lastname: Maleki
authors.affiliation: Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Jamshid
authors.initials: J
authors.lastname: Faghri
keywords: Antimicrobial resistance; Escherichia coli; multidrug resistance; urinary tract infections