title: Antimicrobial resistance in E.coli associated with urinary tract infection in the west of Ireland.
abstract: BACKGROUND
  Knowledge of antimicrobial resistance patterns in E. coli, the predominant pathogen associated with urinary tract infection (UTI) is important as a guide in selecting empirical antimicrobial therapy
  
  
  OBJECTIVE
  To describe the antimicrobial susceptibility of E. coli associated with UTI in a region in the West of Ireland.
  
  
  METHODS
  A collection of 934 E. 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.
  
  
  RESULTS
  More than 50% of E. 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 most E. 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.
  
  
  CONCLUSIONS
  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 associated E. coli.
authors.affiliation: Dept of Bacteriology, National University of Ireland, Galway.
authors.forename: M Ni
authors.initials: MN
authors.lastname: Chulain
authors.forename: A-M
authors.initials: AM
authors.lastname: Murray
authors.forename: G
authors.initials: G
authors.lastname: Corbett-Feeney
authors.forename: M
authors.initials: M
authors.lastname: Cormican
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D000892:Anti-Infective Agents, Urinary / Q000627:therapeutic use*; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects* / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D015994:Incidence; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D012494:Sampling Studies; D012720:Severity of Illness Index; D016482:Urinalysis; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D000892:Anti-Infective Agents, Urinary