Antibiotic resistance of coliform organisms from community-acquired urinary tract infections in Zenica-Doboj Canton, Bosnia and Herzegovina.
OBJECTIVE
To collect routine susceptibility data for coliforms isolated from patients with community-acquired urinary tract infections (UTIs) in Zenica-Doboj Canton, Bosnia and Herzegovina and to relate them to bacterial identification and patient demographics with a view to guiding empirical therapy.


METHODS
During 1998-2001, 54 638 consecutive urine samples were analysed by standard procedures. Antimicrobial susceptibility testing for 15 antimicrobials was performed by the disc diffusion method.


RESULTS
A total of 10 765 Escherichia coli and other coliforms were isolated, of which 5043 (46.8%) were duplicates. Resistance rates were significantly higher in duplicate isolates for almost all antibiotics tested (P<0.05), except for ampicillin, cefazolin, aztreonam and co-trimoxazole. Inclusion of coliforms other than E. coli (25.8%) significantly increased resistance rates for all tested antibiotics (P<0.001) except imipenem. Overall coliform resistance rates were significantly higher in males than in females (P<0.001).


CONCLUSIONS
Due to high ampicillin and trimethoprim/sulfamethoxazole resistance rates for all subsets analysed it is highly recommended to perform urinalysis and antibiotic susceptibility testing in all patients, except in the age group 0-6 years of male patients and in the age group 20-64 years of female patients, in which empirical therapy with these antibiotics can be applied. Nitrofurantoin should also be considered as the first-line therapy, especially in children. It is important for physicians to know susceptibility data for UTIs in order to optimize the use of empirical therapy.
Uzunovic-Kamberovic
Selma
S
Laboratory for Clinical and Sanitary Microbiology, Cantonal Public Health Institution Zenica Fra Ivana Jukica 2/4, 72000 Zenica, Bosnia and Herzegovina. selma_kamb@yahoo.com
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D017522:Bosnia and Herzegovina; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000382:microbiology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D014552:Urinary Tract Infections / Q000382:microbiology*
D000900:Anti-Bacterial Agents