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Antibiotic resistance of Escherichia coli isolated from community-acquired urinary infections

Abstract number: P1271

Topan A., Tatulescu D., Zanc V., Almas A., Flonta M., Slavcovici A.

Objectives: Intensive use of fluoroquinolones in the treatment of urinary infections has led to the spread of resistant microorganisms. The aim of our study is to determine the antimicrobial resistance of uropathogenic Escherichia coli strains isolated from patients admitted in our hospital.

Methods: We retrospectively reviewed medical records of 86 patients aged 18 years or older, with urinary symptoms and cultured documented urinary tract infection (UTI) admitted to our hospital between 1st of January – 31st December 2008. Data abstract from each medical record included demographic aspects; the causative organism; the current use of antibiotics within 3 months; hospitalization within the prior year, previous UTI episodes, complicated or uncomplicated UTI.Hospital stay within prior month; indwelling urinary catheters and residence in long-term care facility were criteria of exclusion. The antibiotic sensitivity was determined by standard disc-diffusion method according to the NCCLS and CLSI standards. Categorical variables were compared using Fisher exact test. Significance was set at p < 0.05.

Results: Among the 86 positive cultures 57 (66.27%) were from female and 29 (33.72%) were from males. Median age of the patients was 61 (range 19–86). The most frequent agent as expected, was Escherichia coli 66.27% (n = 57), followed by Klebsiella pneumoniae 10.46% (n = 9). E. Coli presented a resistance rate to ampicillin of 66.66%, to TMP-SMX of 50.87% and to ciprofloxacin and norfloxacin to 26.33%. E. coli was sensitive to nitrofurantoin in 76.78% cases. E. coli resistant to fluroquinolone was significantly related to: age greater than 65 years (p = 0.048); current use of antibiotics within 3 months (p = 0.0078); prior hospitalization (p = 0.007). There was no statistical significance when we evaluated E. coli fluroquinolone resistant and sex (p = 0.051); previous episodes of UTIs (p = 0.24) or complicated UTIs (p = 0.13).

Conclusions: Resistance of E. coli to fluroquinolones in almost one third of cases shows that the broad use of these drugs needs to be revised. Current use of antibiotics within 3 months, prior hospitalization within 1 year and age over 65 years is a limitation to the use of fluoroquinolones as first choice for empirical therapy in community-acquired UTIs. Nitrofurantoin should be encouraged to use, especially for treatment of non-severe community acquired UTIs.

Session Details

Date: 10/04/2010
Time: 00:00-00:00
Session name: Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Vienna, Austria, 10 - 13 April 2010
Presentation type:
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