Antimicrobial resistance inE. Coli associated with urinary tract infection in the West of Ireland

  • M. Ni Chulain
  • A. -M. Murray
  • G. Corbett-Feeney
  • M. Cormican
Original Paper



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.


  1. 1.
    Farrell DJ, Morrissey I, De Rubeis D, Robbins M, Felmingham D. A UK multicentre study of the antimicrobial susceptibility of bacterial pathogens causing urinary tract infection.J. Infection 2003; 46: 94–100.CrossRefGoogle Scholar
  2. 2.
    Kahlmeter G. An international survey of the antimicrobial susceptibility of pathogens from uncomplicated urinary tract infections: the ECO.SENS Project.J Antimicrob Chemother 2003; 51: 69–76.CrossRefPubMedGoogle Scholar
  3. 3.
    Cormican M, Morris D, Corbett-Feeney-G, Flynn-J. Extended spectrum beta-lactamase production and fluoroquinolone resistance in pathogens associated with community acquired urinary tract infection.Diagn Microbiol Infect Dis 1998; 32: 317–319.CrossRefPubMedGoogle Scholar
  4. 4.
    Warren JW, Abrutyn E, Hebel JR, Johnson JR, Schaeffer AJ, Stamm WE. Guidelines for antimicrobial treatment of uncomplicated acute bacterial cystitis and acute pyelonephritis in women.CID 1999; 29: 745–758CrossRefGoogle Scholar
  5. 5.
    National Committee for Clinical Laboratory Standards. 2000. Performance Standards for Antimicrobial Disk Susceptibility Tests; Approved Standards — Seventh Edition M2-A7.Google Scholar
  6. 6.
    National Committee for Clinical Laboratory Standards. 2002. Performance Standards for Antimicrobial Disk Susceptibility Tests; Twelfth Informational Supplement M100-S12.Google Scholar
  7. 7.
    Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs.Am J Med 2002; 113 Suppl 1A: 5S-13S.CrossRefPubMedGoogle Scholar
  8. 8.
    Hooton TM, Scholes D, Gupta K, Stapleton AE, Roberts PL, Stamm WE. Amoxicillin-clavulanate vc ciprofloxacin for the treatment of uncomplicated cystitis in women: a randomised trial.JAMA 2005; 293: 949–955.CrossRefPubMedGoogle Scholar
  9. 9.
    Cloeckaert A, Chaslus-Dancla E. Mechanisms of quinolone resistance in salmonella.Veterinary Research 2001; 32: 291–300.CrossRefPubMedGoogle Scholar
  10. 10.
    Hummers-Pradier E, Koch M, Ohse AM, Heizman WR, Kochen MM. Antibiotic resistance of urinary pathogens in female general practice patients.Scand J Infect Dis 2005; 37: 256–261.CrossRefPubMedGoogle Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • M. Ni Chulain
    • 1
  • A. -M. Murray
    • 1
  • G. Corbett-Feeney
    • 1
  • M. Cormican
    • 2
  1. 1.Dept of BacteriologyNational University of IrelandGalway
  2. 2.Dept of Medical MicrobiologyUniversity College HospitalGalway

Personalised recommendations