title: Antimicrobial resistance in Escherichia coli outpatient urinary isolates from women: emerging multidrug resistance phenotypes.
abstract: This study evaluated the antimicrobial resistance profile of outpatient urinary Escherichia coli isolated from women obtained throughout Hong Kong during 2004-2005. Of 1067 single patient isolates analyzed, 60.1% were resistant to ampicillin, 34% were resistant to co-trimoxazole, and 22.1% were resistant to ciprofloxacin. Thirty-four (6.6%) of 519 isolates in 2004 and 55 (10%) of 548 isolates in 2005 were extended-spectrum beta-lactamase (ESBL) producers with a CTX-M phenotype. Rates of non-beta-lactam resistance and ESBL production were strongly influenced by patient age. The age-stratified rates for dual co-trimoxazole and ciprofloxacin resistance and for ESBL production were 10.9% and 7.6% in women aged 18-35 years, 13% and 6.9% in women aged 36-50 years, 20.4% and 8.8% in women aged 51-64 years, and 23.7% and 11.8% in women aged > or =65 years, respectively. Nitrofurantoin and fosfomycin remain active against >90% of the isolates, irrespective of the resistance phenotypes for other drugs. Our results documented the emergence of problematic resistance phenotypes among community urinary E. coli and highlight the need to explore strategies for their containment.
authors: Division of Infectious Diseases, Department of Microbiology and Centre of Infection, University of Hong Kong, Pokfulam, Hong Kong SAR, China. plho@hkucc.hku.hk
authors: Pak-Leung
authors: PL
authors: Ho
authors: River C W
authors: RC
authors: Wong
authors: King-Sun
authors: KS
authors: Yip
authors: Shee-Loong
authors: SL
authors: Loke
authors: Marianne S T
authors: MS
authors: Leung
authors: Gannon C
authors: GC
authors: Mak
authors: Frankie K H
authors: FK
authors: Chow
authors: Kenneth W T
authors: KW
authors: Tsang
authors: Tak-Lun
authors: TL
authors: Que
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D024901:Drug Resistance, Multiple, Bacterial; D004926:Escherichia coli / Q000187:drug effects* / Q000201:enzymology; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010045:Outpatients; D010641:Phenotype; D011159:Population Surveillance; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology*; D001618:beta-Lactamases / Q000096:biosynthesis
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases