Antibiotic resistance of urinary pathogens in female general practice patients

Hummers-Pradier, Eva; Koch, Matthias; Ohse, Ann Marit; Heizmann, W.; Kochen, Michael M.

doi:10.1080/00365540410021009

Cited by 28 publications

(28 citation statements)

References 13 publications

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“…Amongst the gram-positive isolates, E. faecalis presented considerable resistance to ciprofloxacin (16.1%). Although with a different methodology, the present study demonstrated similar E. coli resistance rates when compared to the Hummers-Pradier clinical study (15); nevertheless E. faecalis showed a marked difference in the resistance rate to ciprofloxacin (82.8%) if compared to the same study (15). There were also significant differences in the E. coli resistance rates to trimethoprimsulfamethoxazole in comparison to recent studies from other environments, which reported rates from 15-25% in a surveillance (6) and a clinical study (16), and from around 2-15% on isolates with a single crossresistance in another surveillance study (17).…”

Section: E Coli Resistance Rate (%)supporting

confidence: 52%

“…There were also significant differences in the E. coli resistance rates to trimethoprimsulfamethoxazole in comparison to recent studies from other environments, which reported rates from 15-25% in a surveillance (6) and a clinical study (16), and from around 2-15% on isolates with a single crossresistance in another surveillance study (17). This study showed that nitrofurantoin was very active against isolates of E. coli and E. faecalis but not against K. pneumoniae, similar to other studies (6,(15)(16)(17)(18). Furthermore, the present study detected that resistance rates of E. coli, P. mirabilis and K. pneumoniae to ceftriaxone were 0.3%, 0.4% and 1.7%, respectively.…”

Section: E Coli Resistance Rate (%)mentioning

confidence: 34%

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Antibiotic resistance and trend of urinary pathogens in general outpatients from a major urban city

et al. 2007

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Objective:We assessed the antimicrobial resistance patterns of pathogens responsible for urinary tract infections (UTI) in outpatients in São Paulo, Brazil, as well as the Escherichia coli antimicrobial resistance trend. Materials and Methods: Outpatients urine cultures were collected from January 2000 to December 2003. Statistical analysis considered positive results for one bacterial species with colony count ≥ 100,000 CFU/mL. Stratification was done on age group and gender. Statistical tests used included chi-square and the chi-square test for trend to evaluate differences between susceptibility rates among age groups and ordering in the E. coli resistance rates per year, respectively. Results: There were 37,261 positive results with Enterobacteriaceae isolated in 32,530 (87.3%) and Gram-positive cocci in 2,570 (6.9%) cultures. E. coli had the highest prevalence (71.6%). Susceptibility tests were performed in 31,716 cultures. E. coli had elevated resistance rates (> 30%) to ampicillin, trimethoprim-sulfamethoxazole, and tetracycline. Significant differences between age groups and ordering among years were observed. Conclusions: The use of trimethoprim-sulfamethoxazole is precluded in the population studied due to elevated resistance rates (> 30%) among most prevalent pathogens. Significant resistance rate differences among age groups and years were observed, particularly for fluoroquinolones. Fluoroquinolones should be used with caution. Nitrofurantoin should be used as empirical therapy for primary, non-complicated urinary tract infections.

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Section: E Coli Resistance Rate (%)supporting

confidence: 52%

Section: E Coli Resistance Rate (%)mentioning

confidence: 34%

Antibiotic resistance and trend of urinary pathogens in general outpatients from a major urban city

et al. 2007

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“…Indeed, resistance to fluoroquinolones and ESC due to the production of extended-spectrum ␤-lactamases (ESBL) by E. coli isolates has increased steadily over the last 20 years. There is also evidence to suggest that this increase in resistance is linked to the worldwide spread, since 2008, of a specific clone of E. coli, E. coli sequence type 131 (ST131) (4)(5)(6)(7)(8)(9)(10).…”

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confidence: 99%

Escherichia coli ST131, an Intriguing Clonal Group

2014

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SUMMARY In 2008, a previously unknown Escherichia coli clonal group, sequence type 131 (ST131), was identified on three continents. Today, ST131 is the predominant E. coli lineage among extraintestinal pathogenic E. coli (ExPEC) isolates worldwide. Retrospective studies have suggested that it may originally have risen to prominence as early as 2003. Unlike other classical group B2 ExPEC isolates, ST131 isolates are commonly reported to produce extended-spectrum β-lactamases, such as CTX-M-15, and almost all are resistant to fluoroquinolones. Moreover, ST131 E. coli isolates are considered to be truly pathogenic, due to the spectrum of infections they cause in both community and hospital settings and the large number of virulence-associated genes they contain. ST131 isolates therefore seem to contradict the widely held view that high levels of antimicrobial resistance are necessarily associated with a fitness cost leading to a decrease in pathogenesis. Six years after the first description of E. coli ST131, this review outlines the principal traits of ST131 clonal group isolates, based on the growing body of published data, and highlights what is currently known and what we need to find out to provide public health authorities with better information to help combat ST131.

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“…Recent studies have demonstrated that fluoroquinolones are increasingly being used instead of trimethoprim-sulfamethoxazole (TMP-SMX) to treat UTIs in ambulatory women, the majority of whom likely have acute uncomplicated cystitis (9,14,25). Concurrently, and perhaps consequently, fluoroquinolone resistance among uropathogens is increasing in prevalence (5,10). Clearly, strategies that can be used to decrease the rate of fluoroquinolone use, particularly for uncomplicated cystitis, are needed.…”

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confidence: 99%

Risk Factors for Trimethoprim-Sulfamethoxazole Resistance in Patients with Acute Uncomplicated Cystitis

Colgan

Johnson

Kuskowski

et al. 2008

Antimicrob Agents Chemother

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Emerging antimicrobial resistance among uropathogens makes the management of acute uncomplicated cystitis increasingly challenging. Few prospective data are available on the risk factors for resistance to trimethoprim-sulfamethoxazole (TMP-SMX), the drug of choice in most settings. In order to evaluate this, we prospectively enrolled women 18 to 50 years of age presenting to an urban primary care practice with symptoms of cystitis. Potentially eligible women provided a urine sample for culture and completed a questionnaire regarding putative risk factors for TMP-SMX resistance. Escherichia coli isolates were tested for clonal group A (CGA) membership by a fumC-specific PCR. Of 165 women with cystitis symptoms, 103 had a positive urine culture and were eligible for participation. E. coli was the predominant uropathogen (86%). Fifteen (14.6%) women had a TMP-SMX-resistant (TMP-SMX r ) organism (all of which were E. coli). Urinary tract infection (UTI) is one of the most common indications for antimicrobial therapy. Recent studies have demonstrated that fluoroquinolones are increasingly being used instead of trimethoprim-sulfamethoxazole (TMP-SMX) to treat UTIs in ambulatory women, the majority of whom likely have acute uncomplicated cystitis (9, 14, 25). Concurrently, and perhaps consequently, fluoroquinolone resistance among uropathogens is increasing in prevalence (5, 10). Clearly, strategies that can be used to decrease the rate of fluoroquinolone use, particularly for uncomplicated cystitis, are needed.One such strategy is to facilitate the appropriate prescription of TMP-SMX as the preferred agent for the treatment of UTIs in women. The use of TMP-SMX for uncomplicated cystitis is declining (14). The reasons for this are not entirely clear, but a contributing factor may be concerns over the rising rates of TMP-SMX resistance among uropathogens (23). Guidelines for the treatment of acute uncomplicated cystitis recommend the use of alternative agents in settings where TMP-SMX is problematic due to anticipated resistance, intolerance, or other factors (8,26). Unfortunately, local susceptibility data often come from hospital-based microbiology laboratories and may not accurately reflect the prevalence of TMP-SMX resistance among otherwise healthy outpatient women with UTIs, many of whom do not have urine cultures and susceptibilities performed (7). Thus, the actual prevalence of resistance in any given locale is usually unknown or may be overestimated on the basis of hospital-derived data, leading to the unnecessary avoidance of TMP-SMX as a first-line agent.Knowledge of the individual host factors that predict TMP-SMX resistance would allow clinicians to make an informed prescribing decision on a case-by-case basis, eliminating the need to know population-specific resistance rates. Although several studies have attempted to elucidate such individual risk factors, most of those studies have been limited by being retrospective or including mixed gender and age groups that do not fulfill the traditional criteria fo...

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Antibiotic resistance of urinary pathogens in female general practice patients

Cited by 28 publications

References 13 publications

Antibiotic resistance and trend of urinary pathogens in general outpatients from a major urban city

Antibiotic resistance and trend of urinary pathogens in general outpatients from a major urban city

Escherichia coli ST131, an Intriguing Clonal Group

Risk Factors for Trimethoprim-Sulfamethoxazole Resistance in Patients with Acute Uncomplicated Cystitis

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