engleski

Clinical relevance of resistance among urinary tract pathogens

The principal causes of community acquired urinary tract infections are gram-negative bacteria often recognized as resistance problem in hospital settings and thought to be susceptible to antibiotics when causing community acquired infections. We analyzed prospectively 100 adult patients (age 15 to 92) who were admitted to our hospital for acute urinary tract infection (UTI). 28 patients (28%) presented with primary, non-complicated UTI and in all of them the causative agent was E. coli with sensitivity to antibiotics as follows: co-trimoxazole 89%, ampicillin 57%, co-amoxiclav 96%, cefalexin 93%, cefuroxime 93%, ceftazidim 93%, imipenem 100%, gentamicin 93%, netilmicin 100%, amikacin 96%, nitrofurantoin 100%, norfloxacin 100%, ciprofloxacin 100%. Empiric therapy was successful in 96.4% of these patients. In 72 patients UTI was considered to be recurrent, complicated or both. In these patients predominant isolate was still E.coli (83%), followed by Klebsiella spp. (5%). Bacterial isolates in this group of patients showed higher level of resistance to antibiotics, especially co-trimoxazole. Empiric therapy in this group of patients was successful in 87.5% of cases. Antibiotic resistance has a great impact on the treatment of UTIs and empiric therapy should be carefully chosen according to the local antibiotic resistance surveillance data and clinical features of individual patient.

urinary tract ; pathogens

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