Demographic characteristics of patients with community-acquired bacteriuria and susceptibility of urinary pathogens to antimicrobials in northern Israel.
BACKGROUND
Urinary tract infection is one of the most common bacterial infections. Since antibiotics are given empirically, it is necessary to assess the distribution and susceptibility of the microorganisms in each case.


OBJECTIVE
To evaluate the demographic characteristics of ambulatory patients with UTI, the distribution and susceptibility of uropathogens, and the risk factors associated with trimethoprim-sulfamethoxazole resistant bacteria in women.


METHODS
During 12 days in August 1997 all the urine cultures sent to the Tel-Hanan Laboratory (Haifa) were evaluated. Demographic characteristics of the patients, their underlying diseases and the previous use of antibiotics were obtained.


RESULTS
During the 12 day survey 6,495 cultures were sent for evaluation. Of the 1,075 (17%) that were positive 950 were included in the study; 83.7% were from females, of whom 57% were > or = 50 years old. Escherichia coli was the most common pathogen, with 74.7% in the female and 55% in the male population; 86.2% of the E. coli were resistant to amoxicillin, 38.8% to cephalexin and 46.8% to TMP-SMX. Cefuroxime (4.2%), ofloxacin (4.8%), ciprofloxacin (4.8%) and nitrofurantoin (0.4%) showed the lowest rates of resistance. By a multivariant analysis, post-menopause and recurrent UTI were found to be independent factors related to TMP-SMX resistance in women.


CONCLUSIONS
In northern Israel, ampicillin, cephalexin and TMP-SMX cannot be used empirically in the treatment of community-acquired UTI. Post-menopause and recurrent UTI are independent factors associated with TMP-SMX resistant pathogens in women.
Raz
R
R
Infectious Diseases Unit, Central Emek Medical Center, Afula, Israel. raz_r@clalit.org.il
Okev
N
N
Kennes
Y
Y
Gilboa
A
A
Lavi
I
I
Bisharat
N
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000494:pharmacology; D001437:Bacteriuria / Q000453:epidemiology* / Q000382:microbiology; D002506:Cephalexin / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology; D004352:Drug Resistance, Microbial; D004926:Escherichia coli / Q000187:drug effects; D005260:Female; D006801:Humans; D007223:Infant; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000494:pharmacology; D012307:Risk Factors; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology
D000658:Amoxicillin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D015242:Ofloxacin; D002506:Cephalexin