Resumo

Quinolones are a class of antibiotics with a wide range of clinical applications such as genitourinary, respiratory, gastrointestinal and gynecologic infections, as well as sexually transmitted diseases, and some skin and soft tissue infections. However, inappropriate use of these antibiotics increased the emergence of resistant bacterial isolates worldwide. Moreover, quinolone resistant strains can carry additional determinants of resistance, complicating the treatments. In this work, we investigated the presence of the class 1 integrase (intl 1) and ESBL genes in 40 (20 inpatients and 20 outpatients) ciprofloxacin-resistant isolates from patients with urinary tract infection (UTI) attended at the State University Hospital from March 2009 to March 2010.Isolates were identified by conventional methods and antimicrobial susceptibility was determined by disk diffusion method (CLSI, 2009). Specific PCR were carried out to detect Intl1, blaCTX and blaTEM genes. Isolates were identified as E. coli (32/40 - 80%), Klebsiella pneumoniae (7/40 – 17,5%) and Enterobacter spp. (1/40 – 2,5%), which is consistent with the literature, where E.coli is primarily responsible for UTI. Susceptibility results showed that 33/40 (82,5%) were susceptible to cefotaxime; 30/40 (75%) to ceftazidime, 23/40 (57,5%) to cephalothin 27/40 (67,5%) to gentamicin and 5/40 (12.5%) to sulfamethoxazole/trimethoprim. All isolates were susceptible to imipenem. The prevalence of Intl1 was considerably high in those strains obtained from outpatients (6/20 - 30%), which could indicate the spread of nosocomial strains in the community. The eight positive isolates for ESBL phenotypic test were submitted to PCR and showed that 6/8 (75%) contained the genes blaCTX and blaTEM simultaneously. Our study highlights that, despite the resistance to ciprofloxacin, an important and widely used class of antibiotics, many of these strains have accumulated other determinants of resistance, even in community, fact that may seriously limit the effectiveness of the antimicrobial therapy. Keywords: quinolone resistance, class 1 integrons, ESBL, Enterobacteriacea