Susceptibility of Community Gram‐Negative Urinary Tract Isolates to Mecillinam and Other Oral Agents

Mazzulli, Tony; Skulnick, M; Small, G W; Marshall, Wayne K.; Hoban, D.; Zhanel, George G.; Finn, Susan Calvert; Low, Donald E.

doi:10.1155/2001/601743

Cited by 34 publications

(31 citation statements)

References 14 publications

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“…For example, during the periods from 1989 to 1991 and from 1995 to 1997, frequency of detection of ampicillin-and co-trimoxazole-resistant strains increased in the USA from 29% and 7% to 35% and 18%, respectively [4]. Similar data were obtained in studies from Europe and Canada [9,10]. This increase in resistance rates is a consequence of long-term and common use of these antimicrobials not only for treatment of UTI but also for the treatment of other infections, primarily upper and lower respiratory tract infection [11][12][13].…”

Section: Discussionsupporting

confidence: 69%

Antimicrobial susceptibility of pathogens isolated from adult patients with uncomplicated community-acquired urinary tract infections in the Russian Federation: two multicentre studies, UTIAP-1 and UTIAP-2

Stratchounski

Rafalski

2006

International Journal of Antimicrobial Agents

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Section: Discussionsupporting

confidence: 69%

Antimicrobial susceptibility of pathogens isolated from adult patients with uncomplicated community-acquired urinary tract infections in the Russian Federation: two multicentre studies, UTIAP-1 and UTIAP-2

Stratchounski

Rafalski

2006

International Journal of Antimicrobial Agents

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“…The level of fluoroquinolone-resistant E coli was 7%. This is higher than the levels of 1% to 1.8% reported in previous Canadian studies (10)(11)(12). We found that 10% of E coli isolates were fluoroquinolone-resistant in women older than 65 years of age, and this level was found to be 16% in British Columbia.…”

Section: Discussioncontrasting

confidence: 78%

“…Separate results for adult women by age groups were not reported. A 1997 study of urinary tract isolates from family physicians' offices in southern Ontario found that 8.2% of E coli were TMP-SMX-resistant, but the age and sex of the population was not described (11). A comparison of the current study with our previous study of adult women (12) found some increase in TMP-SMX resistance, although the change was not statistically significant.…”

Section: Discussioncontrasting

confidence: 55%

“…However, this method has also been used in other studies that have provided estimates of antibiotic resistance levels in E coli (4,10,11). Although the use of pooled laboratory specimens may overestimate resistance levels (15), this provides greater confidence in the conclusion that the level of TMP-SMX-resistant E coli in acute cystitis seen by family physicians in Canada is significantly less than 20%.…”

Section: Discussionmentioning

confidence: 99%

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Community‐Acquired Antibiotic Resistance in Urinary Isolates from Adult Women in Canada

McIsaac¹,

Mazzulli²,

Permaul³

et al. 2006

Canadian Journal of Infectious Diseases and Medical Microbiolog

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A three-day course of trimethoprim-sulfamethoxazole (TMP-SMX) is recommended as first-line empirical treatment for acute cystitis in adult women in North America, where resistance of Escherichia coli to TMP-SMX is less than 20% (1,2). TMP-SMX resistance has increased over time (3,4), with a resulting shift toward the use of other antibiotics for acute cystitis, including fluoroquinolones (5,6). There is concern that this may promote the more rapid emergence of fluoroquinoloneresistant uropathogens and reduce the effectiveness of fluoroquinolones in treating more serious infections (7,8).Trying to determine the rate of TMP-SMX resistance in community-acquired cases of acute cystitis has been problematic. Widely varying rates of resistance have been reported in different countries (9) and from different regions within the same country (4). In Canada, a study of outpatients attending tertiary care hospitals found that 19% of E coli isolates were resistant to TMP-SMX; however, the study included men and children (10). Two other community-based studies found that 8% (11) and 11% (12) of E coli isolates were resistant to TMP-SMX. We conducted a national study of community-acquired

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“…In case of the present study, nitrofurantoin was found to be the most effective antimicrobial. Resistance to nitrofurantoin among E. coli isolates from UTIs remained low despite of more than 50 year's widespread use of the drug (Kahlmeter 2000, Mazzulli et al 2001. Reason for the lack of emerging resistance are not fully understood, but likely include restricting use to indication for urinary infection, limited systemic absorption, and the need for multiple genetic mutations for the bacteria to develop resistance (Nicolle et al 2006).…”

Section: Table 1 Distribution Of Uropathogens Among Males and Femalesmentioning

confidence: 99%

Antimicrobial Susceptibility Pattern of Escherichia coli Isolated from Uninary Tract Infected Patients Attending Bir Hospital

Sharma

Bhatta

Shrestha

et al. 2013

Nepal Journal of Science and Technology

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Antibiotic resistance among uropathogens is emerging public health problem. This study was done for assessing antibiotic and multidrug resistance (MDR) patterns of Escherichia coli at Bir Hospital, Kathmandu, among suspected urinary tract infection (UTI) patients from January to March, 2011. Altogether, 739 urine samples were analysed by semi-quantitative culture method and uropathogens were identified by conventional methods. E. coli was tested (109 samples) for antimicrobial susceptibility by Kirby Bauer disc diffusion method as per Clinical and Laboratory Standard Institute (CLSI) guidelines. Out of 739 samples, 27.3% gave significant growth while 3.1% and 29.2% samples gave mixed and non-significant growth respectively. E. coli was found to be most predominant isolate (54.0%) followed by coagulase negative Staphylococci (CoNS) (21.3%) and Enterococcus spp. (7.3%). Nitrofurantoin was found to be the most effective antibiotic followed by ciprofloxacin and ofloxacin while cephalexin was least effective. Out of 109 E. coli isolates, 90.8% were MDR strains and most of the isolates had a very high multiple antibiotic resistance (MAR) index, suggesting the origin of the isolates to be of high antibiotic usage. E. coli showed higher rate of resistance towards commonly used oral antibiotics. However, nitrofurantoin is still active against organisms. Thus, nitrofurantoin could be the choice for empirical therapy of UTI.

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Susceptibility of Community Gram‐Negative Urinary Tract Isolates to Mecillinam and Other Oral Agents

Abstract: Community Gram-negative urinary tract isolates remain highly sensitive to mecillinam and ciprofloxacin, but a significant number have developed resistance to trimethoprim/sulfamethoxazole. Further studies are required to determine the clinical significance of these results.

Cited by 34 publications

References 14 publications

Antimicrobial susceptibility of pathogens isolated from adult patients with uncomplicated community-acquired urinary tract infections in the Russian Federation: two multicentre studies, UTIAP-1 and UTIAP-2

Antimicrobial susceptibility of pathogens isolated from adult patients with uncomplicated community-acquired urinary tract infections in the Russian Federation: two multicentre studies, UTIAP-1 and UTIAP-2

Community‐Acquired Antibiotic Resistance in Urinary Isolates from Adult Women in Canada

Antimicrobial Susceptibility Pattern of Escherichia coli Isolated from Uninary Tract Infected Patients Attending Bir Hospital

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