[Lessons to be drawn from one year of surveillance of Escherichia coli in a urology department].
Escherichia coli (E. coli) is the micro-organism most frequently identified in urinary tract infections in adults. The authors analysed the nalidixic acid resistance rate of E. coli isolated over 12 consecutive months in a urology department.


METHODS
All E. coli-positive bacteriological examinations from a urology department during 2004 were retrospectively reviewed. Seventy five bacteriological examinations from 68 patients were positive for E. coli, corresponding to 67 urine cultures, 6 blood cultures and 2 drained collections. Twenty patients had taken fluoroquinolones during the previous 6 months and 10 patients were diabetic. A nalidixic acid-resistant (NR) E. coli was isolated in 11 patients (16%) aged 22 to 81 years (median: 58 years). Patients with nalidixic acid-resistant (NR) E. coli were compared to patients with nalidixic acid-susceptible (NS) E. coli.


RESULTS
Predictive factors for nalidixic acid resistance of E. coli were fever higher than 38.4 degrees C (p = 0.022), leukocytosis (p = 0.002) and use of fluoroquinolones during the previous 6 months (p = 0.046).


CONCLUSIONS
Prescription of a non-fluoroquinolone antibiotic may be preferable in the case of recent use of fluoroquinolones and signs of severe infection (leukocytosis and fever higher than 38.4 degrees C).
Bruyère
Franck
F
Service d'Urologie, CHU Bretonneau, Tours, France. f.bruyere@chu-tours.fr
Lanotte
Philippe
P
D'Arcier
Benjamin Faivre
BF
Bou
Sopheap
S
Haillot
Olivier
O
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D048909:Diabetes Complications / Q000382:microbiology; D004927:Escherichia coli Infections / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014552:Urinary Tract Infections / Q000382:microbiology*