Risk Factors for Trimethoprim and Sulfamethoxazole-Resistant Escherichia Coli in ED Patients with Urinary Tract Infections

Cystitis in pediatric age group and its empirical therapy in a coastal region of southern India

“…Study conducted by Duployez C et al [13] had Ecoli susceptibility to Trimethoprim/sulfamethoxazole of 78%. Wesolek JL et al [14] in their study had 74.9% sensitivity to Trimethoprim/sulfamethoxazole. Since the susceptibility of uropathogens to Trimethoprim/sulfamethoxazole is high and is cost effective when compared to other antibiotics and it can also be administered orally without regards to meals [15], and only barring those children with risk factors [16], Trimethoprim/sulfamethoxazole can still be considered as an empiric drug of choice especially in the developing countries in paediatric age group for acute uncomplicated cystitis.…”

Commensal strains of E. coli involved in infections in patients at the Hospital Juarez de Mexico

“…B-lactams, fluoroquinolones, TMP-SMX, and Nitrofurantoin are the antibiotics recommended for antibiotic therapy in E. coli infections 37 ; in this work, resistance was observed particularly to TMP-SMX, ciprofloxacin, and 3 rd /4 th generation cephalosporins (FEP, CRO), in a SENTRY type epidemiological surveillance study in which isolates collected from 1997 to 2016 were analyzed, increased resistance was observed particularly to 3 rd -and 4 th -generation cephalosporins as well as fluoroquinolones 38 . TMP-SMX is one of the first-line empirical therapies for the treatment of acute uncomplicated cystitis, resistance rates to this antibiotic have been reported to be > 20% for E. coli, the isolates analyzed in this work showed resistance mainly to this antibiotic so that empirical therapy with TMP-STX should be reconsidered 39 . Phenotypic tests to evidence ESBL production showed that 65% of E. coli isolates were producers of this resistance mechanism, this type of enzyme is directly related to resistance to cephalosporins, in addition to being the most frequent resistance mechanism in this bacteria 38,40,41 , the strains analyzed showed resistance to the antibiotics recommended in antibiotherapy, which limits treatment options and forces health personnel to escalate therapy to antimicrobial therapy, carbapenems are one of the last treatment options against serious infections caused by Gramnegative bacteria 42 , although carbapenems in this work had low percentages of resistance, four isolates were detected with coding genes for carbapenemases; in other work, these resistance mechanisms have also been reported in isolates of E. coli 43 .…”

Regional variations in antimicrobial susceptibility of community-acquired uropathogenic Escherichia coli in India: Findings of a multicentric study highlighting the importance of local antibiograms

“…The rapid emergence and proliferation of multi-drug resistant uropathogens—often harboring ESBLs, AmpC enzymes, and carbapenemases—makes the treatment of even simple UTIs more challenging, often rendering empirically used antimicrobials inactive [ 9 ]. Providing relevant antibiograms to clinicians is vital to addressing this issue; it is also vital to stratify by whether UTI isolates are from in- or out-patients [ 10 ]. The treatment of UTIs in India follows national and international guidelines; however, the large regional variations observed in our study suggest that management should be tailored to reflect local resistance rates [ 11 , 12 ].…”