The prevalence and risk factors of fluoroquinolones and co-trimoxazole resistant Escherichia coli in the Northwest Iran: A retrospective cohort

Introduction: Fluoroquinolone (FQ) and co-trimoxazole (STX) are the most effective antibiotics for Escherichia coli; however, antibiotic resistance has become an ever-increasing challenge. The current study investigates the prevalence rate and risk factors for developing FQ and STX resistance in Northwest Iran. Methods: This is a retrospective cohort study of 314 patients admitted to Sina Hospital, the academic hospital affiliated with Tabriz University of Medical Sciences, Iran, between 21st March 2017 to 20th March 2018. Based on specimen culture, patients were divided into two groups, i.e., FQ or SXT-resistant E. coli and the antibiotics sensitive. The potential risk factors for developing FQ or SXT-resistant E. coli were studied in the included patients. Results: FQ and SXT-resistant E. coli prevalence was 66.3% and 70%, respectively. Univariate analyses showed that type II diabetes mellitus, prior antibiotic use, prior FQ administration, prior admission, prior urinary tract infection, urinary catheterization, and anemia were the significant risk factors for developing FQ-resistant E. coli infection. The univariate analyses indicated that prior antibiotic use, hospitalization in an intensive care unit (ICU), and urinary catheterization were the significant risk factors for developing SXT-resistant E. coli infection. FQ and SXT-resistant E. coli infections are prevalent in our region. Prior antibiotic use and urinary catheterization are the common risk factors for developing FQ and SXT-resistant E. coli in our region. Conclusion: Type II diabetes mellitus, prior urinary tract infection, gentamicin resistance, prior FQ administration, and extended-spectrum β-lactamases (ESBL) production are risk factors for developing FQ-resistant E. coli and ESBL production is the risk factor for developing STX-resistant E. coli in our region.