<![CDATA[Background: Escherichia coli (E. coli) is a major cause of urinary tract infection (UTI). The emerging resistance of E. coli against beta-lactams and or carbapenem lead to the increased use of fluoroquinolone (ciprofloxacin or levofloxacin) in clinical practice. Data of E. coli susceptibility, particularly regarding the extended-spectrum beta lactamase (ESBL) expression and carbapenem or fluoroquinolone resistance can be important for clinical treatment.Objectives: This study aimed to describe the susceptibility profile of ESBL producing E. coli isolates, as well as their resistance against carbapenem and fluoroquinolone. In addition, the use of ciprofloxacin in predicting levofloxacin against the E. coli isolates was analyzed.Methods: A retrospective analytic study was conducted on 135 laboratory records of E. coli isolated from urine culture of adult patients at FMPHN UGM (2007-2022). Proportion of ESBL phenotype, as well as carbapenem, ciprofloxacin and levofloxacin resistance were calculated and augmented by kappa score and plots matrix analysis.Results: The ESBL producer E. coli as well as their resistances to carbapenem and ciprofloxacin were observed in 71(53.78%) of the 132 isolates, 23(17.04%), and 82(60.74%) of the 135 isolates respectively. Among 108 E. coli isolates which tested against both ciprofloxacin and levofloxacin, phenotypic ESBL resistances to carbapenem, ciprofloxacin and levofloxacin were identified in 56(52.33%), 21(19.44%), 80(74.07%), and 60(55.55%) respectively. The kappa score (κ=0.6222) and plots matrix showed the moderate agreement of ciprofloxacin to predict levofloxacin susceptibility against E. coli isolates.Conclusion: The E. coli resistances against beta-lactams, carbapenem, ciprofloxacin and levofloxacin were alarming. In addition, both ciprofloxacin and levofloxacin are needed to be regularly tested because ciprofloxacin susceptibility results cannot accurately predict levofloxacin susceptibility.]]>
