Multiple resistances to antimicrobial drugs arising in Escherichia coli isolates may complicate therapeutic management of urinary tract infection (UTI) by this organism. In order to assess the multidrug resistance (MDR) among urinary E. coli isolates, we have tested 11 antimicrobial drugs against 67 isolates from outpatients attended in a tertiary-care teaching hospital and of 78 isolates from a municipal health unit, respectively in Ribeirão Preto, State of São Paulo, Brazil. Seventy-six percent and 22% of the isolates from the tertiary-care hospital and the municipal unit, respectively, were resistant to three or more different classes of agents, and were considered to present MDR. Among the isolates from the hospital patients, 73.0%, 65.0%, 58.0%, 58.0% and 31.0% were resistant to tetracycline, ampicillin, cephalothin, trimethoprim-sulfamethoxazole (TMP/SMX) and norfloxacin, respectively; resistance from the municipal unit patients were 31.0%, 37.0%, 8.0%, 29.0% and 12.0% respectively, to the same drugs. The predominant phenotype among the MDR isolates presented is ampicillin, TMP/SMX and tetracycline resistance. The high prevalence of drug resistance among UTI patients calls for continuous surveillance to assure effective control of this infection.

hallucinations is unusual for intoxication with atropine or scopolamine, but could be explained by delayed digestion of non-ground Jimson weed seeds. Postprandial 'inability to vomit', followed by unconsciousness and auditory hallucinations, as reported by this patient, clearly is consistent with tropane alkaloid poisoning, and, together with laboratory results (50 seeds D. stramonium/kg of grain), confirm contamination by Jimson weed to be the cause of this event. Foodborne disease outbreaks are recognized by the occurrence of illness within a variable but usually short time period after a meal, among individuals who have consumed foods in common. Prompt and thorough laboratory evaluation of cases and implicated foods is essential. Food poisoning due to Jimson weed may mimic B. cereus food intoxication and therefore should be considered as a differential diagnosis. The increasing propagation of organic farming with the refusal to use pesticides may increase the occurrence of food poisoning due to Jimson weed in the future. Conflict of interest: No conflict of interest to declare.