[Increasing antibiotic resistance in urinary tract infections].
BACKGROUND
There is increasing focus on the development of bacterial antibiotic resistance.


METHODS
We conducted a retrospective study of urine samples from patients resident in a Norwegian county, comparing 9121 samples culture-positive in 2003-04 with 28 066 samples in 1997-99. Determination of resistance was done with the MAST automatic multipoint inoculator system.


RESULTS
Escherichia coli was found in 68% and 56% of out-patient and in-patient isolates respectively. Significant declines in mecillinam sensitivity (from 96% to 94%), nitrofurantoin sensitivity (from 97% to 95%) and sulfonamide sensitivity (from 73% to 71%) in in-patient E. coli isolates were found. In out-patients we found significant reductions in sensitivity to ampicillin (from 78% to 76%) and trimethoprim (from 83% to 82%). For urinary tract infection isolates as a whole, the greatest sensitivity was observed for nitrofurantoin: 85% in in-patient isolates and 75% in out-patient isolates, but there was a significant decline in resistance to several antibiotics.


CONCLUSIONS
Increasing antibiotic resistance may be related to increasing antibiotic use. Mecillinam and nitrofurantoin may be considered first-choice preparations as E. coli is the dominant etiological agent and shows the greatest sensitivity to these two antibiotics.
Skudal
Hilde K
HK
AS Telelab, Mikrobiologisk avdeling, Postboks 1868 Gulset, 3703 Skien. hilde.skudal@akersykehus.no
Grude
Nils
N
Kristiansen
Bjørn-Erik
BE
D000892:Anti-Infective Agents, Urinary / Q000008:administration & dosage / Q000009:adverse effects; D024881:Drug Resistance, Bacterial; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000652:urine; D006801:Humans; D007297:Inpatients; D009664:Norway; D010045:Outpatients; D012189:Retrospective Studies; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology / Q000652:urine
D000892:Anti-Infective Agents, Urinary