Antimicrobial resistance in community and nosocomial Escherichia coli urinary tract isolates, London 2005 – 2006
2008

Antimicrobial Resistance in E. coli Urinary Tract Infections

Sample size: 11865 publication Evidence: high

Author Information

Author(s): David C Bean, Daniel Krahe, David W Wareham

Primary Institution: Barts and The London NHS Trust

Hypothesis

What are the levels of resistance to commonly used antimicrobial agents among E. coli urinary isolates?

Conclusion

Resistance to commonly used oral treatments for urinary tract infections is extremely high, except for nitrofurantoin.

Supporting Evidence

  • Nitrofurantoin was 94% effective against E. coli.
  • Resistance to ampicillin was found in 55% of isolates.
  • Trimethoprim resistance was observed in 40% of isolates.
  • 5.7% of community isolates showed resistance to cefpodoxime.
  • 21.6% of nosocomial isolates showed resistance to cefpodoxime.

Takeaway

Doctors found that most E. coli bacteria causing urinary infections are resistant to many common antibiotics, so they need to be careful about which ones to use.

Methodology

Antimicrobial susceptibility was tested using the BSAC disc diffusion method on 11,865 E. coli urinary isolates collected over one year.

Potential Biases

Higher resistance rates in males may reflect more complicated urinary tract infections.

Limitations

The study may overestimate resistance rates as urine samples are often sent for testing only after treatment failures.

Participant Demographics

88.7% community isolates, 11.3% nosocomial; 85.7% from women, 14.0% from men, and 10.3% from children under 16.

Statistical Information

P-Value

≤0.001

Confidence Interval

95% CI

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/1476-0711-7-13

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