Urinary Tract Infections Associated with Escherichia Coli: A 2005 to 2009 Clinical Assessment of Trends in Fluoroquinolones Activities in Maiduguri-City, Nigeria.

ABSTRACT

Urinary Tract Infections caused by Escherichia coli were investigated for infectivity patterns, trends in sensitivity to fluoroquinolones, multi-fluoroquinolone resistant pattern and the fluoroquinolones’ inter-activities relation. 1590 patients (785/805 male/female) with clinical symptoms suggestive of UTI and confirmed with microbiological assay of the mid-stream of early morning urine specimens were surveyed. Isolated pathogens were cultured and sensitivity tests were performed. UTI cases increased by 17.7% between 2005 and 2009 with Escherichia coli accounting for 41% and showing an increase from 5.7% in 2005 to 28.0% in 2009 and a significant correlation (P<0.05). E. coli-UTIs were higher in females (56.6%) than males (43.4%). Pathogen’s susceptibility to agents varied but the activities of ciprofloxacin, ofloxacin, pefloxacin and nalidixic acid against E. coli recorded significant yearly decrease (P<0.05). The overall susceptibilities of E. coli were 71%, 58%, 48%, 34% and 15% for ofloxacin, ciprofloxacin, pefloxacin, norfloxacin and nalidixic acid respectively. About 35% of ciprofloxacin-resistant E. coli indicated sensitivity to ofloxacin whereas only 20% was the converse. Multifluoroquinolones- resistant cases (282, 43.6%) were observed in E. coli which increased from 30.2% in 2006 to 57.5% in 2009. The study observed a rapid and progressive loss of activities of quinolones, increasing multifluoroquinolone- resistant, high resistance rates and poor inter-activities relations between the fluoroquinolones against E. coli in the region.