Resistance and susceptibility among urinary tract infections isolates of Escherichia Coli from female outpatients

Abstract

Introduction: Urinary tract infections are the most common bacterial infections in women and account for significant morbidity and health care costs. A limited and predictable spectrum of organisms cause urinary tract infections in young, otherwise healthy females. Among both outpatients and inpatients, Escherichia coli is the primary urinary tract pathogen, accounting for 75 to 90% of uncomplicated urinary tract infection isolates. Staphylococcus saprophyticus, Klebsiella spp., Proteus spp., Enterococcus spp., and Enterobacter spp. are pathogens less commonly isolated from outpatients. Aim: The present study was conducted to determine regional, and institutional in vitro susceptibilities for ampicillin, ciprofloxacin, nitrofurantoin, and SXT among urine isolates of E. coli from female outpatients from Urology Department of Emergency Hospital,Targu Mures from Romania. In addition, the rate of change in susceptibilities to these four commonly tested antimicrobial agents over 3 years, from 2012 to 2014, was also determined.

Materials and Methods: We retrospectively reviewed 272 patients with a urinary tract infection with Escherichia Coli starting in 01.01.2012 to 31.12.2014 from Urology Departament by Emergency County Hospital Targu Mures. The susceptibility testing results(by Kirby-Bauer technique) included in the analysis were restricted to urine isolate of E. coli submitted per calendar year by female outpatients of all ages. We will provide data about the evolution under this treatment. All statistical analisys were performed using GraphPad Prism 6.0. Results: Ampicillin, ciprofloxacin, nitrofurantoin, and SXT susceptibilities for urine isolates of E. coli from female outpatients during the years 2012 through 2014: for the Ampicillin (susceptibility 32%, resistance 66,2%, p<0.0001), for the Ciprofloxacin (susceptibility 60,8%, resistance 38,4%, p<0.0001), for the Nitrofurantoin (susceptibility 92,8% resistance 5,8%, p<0.0001) and SXT (susceptibility 56,2,%resistance 43,1, p<0.0001).

Conclusion: Given that E. coli is the principal pathogen in urinary tract infections, particularly among outpatients, resistance to nitrofurantoin in E. coli infections is an important indicator of whether nitrofurantoin should continue to be used empirically while we wait the antibiogram.