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Trends in Antimicrobial Resistance among Urinary Tract Infection Isolates of Escherichia coli from Female Outpatients in the United States
Open accessAbstract
The Infectious Diseases Society of America advocates trimethoprim-sulfamethoxazole (SXT) as initial therapy for females with acute uncomplicated bacterial cystitis in settings where the prevalence of SXT resistance does not exceed 10 to 20%. To determine trends in the activities of SXT, ampicillin, ciprofloxacin, and nitrofurantoin among urine isolates of Escherichia coli from female outpatients, susceptibility testing data from The Surveillance Network (TSN) Database-USA ( n = 286,187) from 1995 to 2001 were analyzed. Resistance rates among E. coli isolates to ampicillin (range, 36.0 to 37.4% per year), SXT (range, 14.8 to 17.0%), ciprofloxacin (range, 0.7 to 2.5%), and nitrofurantoin (range, 0.4 to 0.8%) varied only slightly over this 7-year period. Ciprofloxacin was the only agent studied that demonstrated a consistent stepwise increase in resistance from 1995 (0.7%) to 2001 (2.5%). In 2001, SXT resistance among E. coli isolates was >10% in all nine U.S. Bureau of the Census regions. At institutions testing ≥100 urinary isolates of E. coli ( n = 126) in 2001, ampicillin (range, 27.3 to 98.8%) and SXT (range, 7.5 to 47.1%) resistance rates varied widely while ciprofloxacin (range, 0 to 12.9%) and nitrofurantoin (range, 0 to 2.8%) resistance rates were more consistent. In 2001, the most frequent coresistant phenotypes were resistance to ampicillin and SXT (12.0% of all isolates; 82.3% of coresistant isolates) and resistance to ampicillin, ciprofloxacin, and SXT (1.4% of all isolates; 9.9% of coresistant isolates). Coresistance less frequently included resistance to nitrofurantoin (3.5% of coresistant isolates) than resistance to ciprofloxacin (15.8%), SXT (95.7%), and ampicillin (98.1%). In conclusion, among urinary isolates of E. coli from female outpatients in the United States, national resistance rates to SXT were relatively consistent (14.8 to 17.0%) from 1995 to 2001 but demonstrated considerable regional and institutional variation in 2001. Therapies other than SXT may need to be considered in some locations.
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Talan, D. A., Stamm, W. E., Hooton, T. M., Moran, G. J., Burke, T., Iravani, A., Reuning-Scherer, J., & Church, D. A. (2000) · JAMA · doi:10.1001/jama.283.12.1583
Cited by
The epidemiology of urinary tract infection
Foxman, B. (2010) · Nature Reviews Urology · doi:10.1038/nrurol.2010.190 · Cited by 1,771
Arslan, H., Azap, Ö. K., Ergönül, Ö., & Timurkaynak, F. (2005) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dki344 · Cited by 286
Hussein, M., Sun, Z., Hawkey, J., Allobawi, R., Judd, L. M., Carbone, V., Sharma, R., Thombare, V., Baker, M., Rao, G. G., et al. (2024) · mSystems · doi:10.1128/msystems.00972-23 · Cited by 14
Metadata
- Authors
- Karlowsky, J. A., Kelly, L. J., Thornsberry, C., Jones, M. E., & Sahm, D. F.
- Venue
- Antimicrobial Agents and Chemotherapy
- Publisher
- American Society for Microbiology
- Published
- 2002-08
- Volume
- 46
- Issue
- 8
- Pages
- 2540-2545
- ISSN
- 0066-4804 (ISSN-L)
- 1098-6596
- OpenAlex
- W2113664107
- Cited by
- 367
- References
- 1
- FWCI
- 11.17
- Type
- journal article
- Language
- en
- Open access
- green
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- Karlowsky, J. A., Kelly, L. J., Thornsberry, C., Jones, M. E., & Sahm, D. F. (2002). Trends in Antimicrobial Resistance among Urinary Tract Infection Isolates of Escherichia coli from Female Outpatients in the United States. Antimicrobial Agents and Chemotherapy. https://doi.org/10.1128/aac.46.8.2540-2545.2002
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