engleski

Antibiotic resistance among uropathogens - overestimated problem or reality

Urinary tract infections (UTI) are acute infections that need to be treated with antibiotics promptly, before the causative agent and its sensitivity pattern are known. Data from the Croatian Committee for Antibiotic Resistance Surveillance suggest high rates of resistance to co-trimoxazole and ampicillin in E. coli and other enterobacteriaceae. However, these data do not refer to the urinary tract isolates specifically. We have therefore analyzed urinary tract isolates from patients treated for UTI in the outpatient department of the University Hospital for Infectious Diseases, Zagreb or admitted for UTI to the same hospital in the period 1.1. - 31.12. 2000. Among 906 isolates of E. coli resistance to co-trimoxazole was 23% and to ampicillin 47% which was almost identical to the national data for E. coli. Resistance to quinolones (2%) was somewhat lower than the average for Croatia (6%). However, there were marked differences among resistance rates when UTI patients were divided into subgroups. E. coli was resistant to co-trimoxazole in 31% of patients treated in the outpatient department for urogenital infections, in 25% of male and 19% of female patients in the general outpatient department. In patients admitted to hospital resistance to co-trimoxazol in E. coli did not differ much between patients with acute uncomplicated UTI (15%) and those with complicated UTI (12%), but when all the bacterial species were taken into account co-trimoxazole resistance was 12% in patients with uncomplicated UTI and 26% in patients with complicated UTI. There was also no resistance to quinolones in patients with uncomplicated UTI, whereas in patients with complicated UTI quinolone resistance rate was 8%. Resistance to co-amoxiclav and gentamicin, the two most widely used antibiotics in the treatment of patients hospitalized for UTI was 8% and 7% in patients with uncomplicated UTI and 17% and 19% in patients with complicated UTI. In conclusion, antibiotic resistance is more expressed in patients with complicated UTI, but even in the group of patients with acute uncomplicated UTI resistance to co-trimoxazole exceeds 10% and to ampicillin 30%. In patients with complicated UTI additional worry is resistance to co-amoxiclav (17%) and gentamicin (19%).

Urinary tract infections (UTI); antibiotic resistance

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