Ten years surveillance of antimicrobial susceptibility of community-acquired Escherichia coli and other uropathogens in northern Israel (1995-2005).
BACKGROUND
In an era of increasing antimicrobial resistance, knowledge of local antimicrobial susceptibility patterns of common uropathogens is essential for prudent empiric therapy of community-acquired urinary tract infections.


OBJECTIVE
To define antimicrobial susceptibility of Gram-negative uropathogens in northern Israel over a 10 year period and to compare it with patterns of antibiotic use in the same community.


METHODS
We tested the susceptibility of all Gram-negative urinary isolates from outpatients at HaEmek Medical Center over the years 1995, 1999, 2002 and 2005 to common antimicrobial agents. MIC90 of Escherichia coli to some of these agents was determined and antibiotic consumption data over the years 2000-2005 (DDD/1000/day) were obtained.


RESULTS
We observed a rise in susceptibility rates of E. coli to amoxicillin-clavulanate, trimethoprim-sulfamethoxazole and nitrofurantoin and of other Gram-negative isolates to amoxicillin-clavulanate, ceftriaxone and cephalothin. Susceptibility rates of all Gram-negative uropathogens to ciprofloxacin decreased significantly. MIC90 of E. coli for all drugs tested remained stable. There was a significant decrease in the use of nitrofurantoin and TMP-SMX and a significant increase in the use of ampicillin, cephalothin and ceftriaxone.


CONCLUSIONS
Antibiotic resistance patterns mostly remained unchanged or improved slightly. There was, however, a constant decrease in susceptibility of all Gram-negative uropathogens to ciprofloxacin. Antibiotic use patterns could not explain the changes seen in antibiotic susceptibility patterns.
Rock
Wasseem
W
Department of Internal Medicine C, HaEmek Medical Center, Afula, Israel. wasseem_rock@yahoo.com
Colodner
Raul
R
Chazan
Bibiana
B
Elias
Mazen
M
Raz
Raul
R
D019980:Amoxicillin-Potassium Clavulanate Combination / Q000494:pharmacology / Q000627:therapeutic use; D000892:Anti-Infective Agents, Urinary / Q000494:pharmacology* / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000494:pharmacology; D017714:Community-Acquired Infections / Q000188:drug therapy; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects*; D004927:Escherichia coli Infections / Q000188:drug therapy; D006090:Gram-Negative Bacteria / Q000187:drug effects; D006801:Humans; D007557:Israel; D008826:Microbial Sensitivity Tests; D009582:Nitrofurantoin / Q000494:pharmacology / Q000627:therapeutic use; D011159:Population Surveillance; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D014552:Urinary Tract Infections / Q000188:drug therapy*
D000892:Anti-Infective Agents, Urinary; D002939:Ciprofloxacin; D019980:Amoxicillin-Potassium Clavulanate Combination; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D009582:Nitrofurantoin