Resistance trends of E. coli from urinary tract infections in hospitalised patients and consumption of antimicrobials, 19982006
Abstract number: P2103
Baklan Z., Saletinger R., Drofenik P., Novak D.
Objectives: To find out the frequency of E. coli among urinary pathogens and to investigate the resistance trends of E. coli to antimicrobials and the consumption of antimicrobials in hospital in period 1998 to 2006.
Methods: We analysed all pathogens from urine samples from patients hospitalised at University Clinical Centre Maribor. Urine cultures were done according to standard techniques and susceptibility was determined according to NCCL standards by disc diffusion method.
Results: In 1998 and 2006, 2563 and 3005 pathogens from urine cultures were analysed. The frequency of Gram-negative bacteria increased (from 64.7% to 75.9%) and E. coli was the most common pathogen determined, representing 39.1% (N=1002) and 44.6% (N=1339) of all isolates.
The resistance rates of E. coli to some most often used antimicrobials in period 19982006 were as follows: to amoxicillin-clavulanate 15.4% and 13.3% (p-NS), to cephalotin 7.8% and 16.8% (p < 0.001), to cefuroxime 2.8% and 3.2% (p-NS), to ciprofloxacin 4.9% and 13.0% (p < 0.001), to gentamicin 2.3% and 5.3% (p < 0.001), to cotrimoxazole 15.0% and 26.1% (p < 0.001).
The consumption of some antimicrobial agents in our clinic in period 19982006 was as follows (in DDD/100 hospital days): amoxicillin-clavulanate 100006 and 140809, cefuroxime 43404 and 100356, gentamicin 15908 and 13300, ciprofloxacin 41592 and 106513.
Conclusion:E. coli remains the most frequently isolated pathogen. A considerable rise in the resistance rates of E. coli to cephalotin, ciprofloxacin, gentamicin and cotrimoxazole was detected. Amoxicillin-clavulanate was the only one with slightly improved susceptibility, although it was the most often prescribed antimicrobial agent to inpatients and outpatients too. In 2006 we found the resistance rates of E. coli lower than 10% only to cefuroxime and to gentamicin. ESBL-producing strains among E. coli were detected in 1.5%.
We believe that it is necessary to rationalize persciption of ciprofloxacin in our clinic in order to prevent a further increase of resistance. Knowledge of most frequent uropathogens and their antimicrobial resistance patterns is essential to provide clinically successful, cost effective antimicrobila therapy for urinary tract infections.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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