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Susceptibility of urinary pathogens in a dublin teaching hospital

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Abstract

The range and resistance patterns of organisms causing urinary tract infections (UTI) vary with time and place. A prospective study of midstream urine (MSU) specimens, received over a 3 month period, was therefore undertaken.

The antibiotic sensitivities of 528 isolates from 196 domiciliary and 332 hospitalised patients with significant bacteruria (>105 organisms/ml) were determined using the modified Stokes method.Escherichia coli accounted for 79% of domiciliary isolates and 57% in hospitalised patients. Gram positive organisms causing UTI have become increasingly common and were isolated from 8% and 15% of domiciliary and hospitalised patients respectively.

Resistance levels for co-amoxiclav (Augmentin) were low (7% domiciliary, 14% hospitalised). However 46 Gram negative isolates (10%) had intermediate sensitivities to co-amoxiclav on disc testing. Breakpoint testing showed 89 % of these to be sensitive at the urinary breakpoint but only 52% were sensitive at the systemic breakpoint.

Forty nine percent ofE. coli from hospital specimens were resistant to pipercillin, due to TEM-1 beta lactamase production. A 6% resistance level to ciprofloxacin in domiciliaryE. coli is considerably higher than previous reports and gives cause for concern. Gentamicin resistance was found in 4% of Gram negative hospital isolates, a finding of some significance in the empiric treatment of septicaemia of urinary tract origin.

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Authors and Affiliations

  1. Departments of Microbiology, Beaumont Hospital, Dublin 9

    R. J. Cunney, R. M. McNally, E. M. McNamara, N. Al-Ansari & E. G. Smyth

  2. Department of Microbiology, Royal College of Surgeons in Ireland, 123 St. Stephen’ s Green, Dublin 2

    R. J. Cunney & E. M. McNamara

Authors
  1. R. J. Cunney
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  2. R. M. McNally
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  3. E. M. McNamara
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  4. N. Al-Ansari
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  5. E. G. Smyth
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Cunney, R.J., McNally, R.M., McNamara, E.M. et al. Susceptibility of urinary pathogens in a dublin teaching hospital. I.J.M.S. 161, 623–625 (1992). https://doi.org/10.1007/BF02983767

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  • DOI: https://doi.org/10.1007/BF02983767

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