Introduction. The increasing antimicrobial resistance of Escherichia coli remains a significant challenge in contemporary urological practice, particularly in men with chronic prostatitis and bacteriospermia. During the SARS-CoV-2 pandemic, the widespread and often empirical use of antibacterial agents, including fluoroquinolones, may have contributed to the selection of resistant strains. Therefore, assessing regional trends in
E. coli susceptibility to fluoroquinolones and the potential impact of non-antibacterial approaches, including OM-89 as part of combination therapy, is of particular clinical relevance.
Objective. The aim of the study is to analyze the changes in the resistance and prevalence of E. сoli to fluoroquinolones before and after the SARS-COV2 pandemic.
Materials and methods. A retrospective bacteriological analysis of ejaculate was conducted, revealing 303 strains of E. сoli from 2015 to 2024 at the bacteriological laboratory of the M.B. Stoyunin Anti-Tuberculosis Dispensary in Ivanovo. The sensitivity of E. Coli to the main fluoroquinolones was assessed according to the criteria set by the European Committee on Antimicrobial Susceptibility Testing (EUCAST). Statistical analysis was performed using Microsoft Excel 2020 and Statistica 12.0 (StatSoft, Inc.) through multiple regression methods, Kruskal-Wallis, and Fisher’s tests. Results. The prevalence of E. сoli decreased from 2015 to 2024. A consistent trend of increasing significant titers of E. Coli strains was observed during this period. The resistance of E. сoli to all studied fluoroquinolones significantly increased, peaking in 2022. The use of non-antibacterial agents, specifically OM-89 (Uro-Vaxom®), in combination therapy with antibacterial drugs helps to reduce resistant strains of E. сoli in the general population.
Conclusion. The increased use of fluoroquinolones due to the SARS-COV2 pandemic has led to a sharp rise in resistant strains of E. сoli. Therefore, it is essential to reduce the use of this group of antibacterial drugs without determining their sensitivity. Our experience with the use of OM-89 (Uro-Vaxom®) in the combined therapy of chronic prostatitis allows for the restoration of sensitivity and a reduction in the number of resistant E. сoli strains to fluoroquinolones, which will help preserve their effectiveness for treating more severe cases.
