Antimicrobial resistance inE. Coli associated with urinary tract infection in the West of Ireland
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Knowledge of antimicrobial resistance patterns inE. coli, the predominant pathogen associated with urinary tract infection (UTI) is important as a guide in selecting empirical antimicrobial therapy.
To describe the antimicrobial susceptibility ofE. coli associated with UTI in a region in the West of Ireland.
A collection of 934E. coli isolates associated with UTI were tested for susceptibility to a panel of antimicrobial agents by the disc diffusion method of the National Committee for Clinical Laboratory Standards.
More than 50% ofE. coli were resistant to ampicillin, more than 40% resistant to sulphonamide and more than 30% resistant to trimethoprim. From 7.9% (community) to 12.5% (hospital) are resistant to co-amoxiclav with approximately 20% of isolates of intermediate susceptibility. In general practice mostE. coli remain susceptible to nitrofurantoin (96.7%), nalidixic acid (93.9%) and ciprofloxacin (94.7%). For all agents rates of resistance were higher in hospital as compared with general practice isolates. Three isolates with the phenotype of Extended Spectrum Beta-lactamase (ESBL) resistance were detected.
Ampicillin/amoxicillin are not suitable for empiric therapy of UTI in general practice or hospital patients in this region. There is doubt as to the role of trimethorpim or co-trimoxazole for empiric therapy of UTI. Nitrofurantoin, nalidixic acid and ciprofloxacin are active against the great majority of UTI associatedE. coli.
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