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Nitrofurantoin retains antimicrobial activity against multidrug-resistant urinary Escherichia coli from US outpatients.
Sanchez, G V; Baird, A M G; Karlowsky, J A; Master, R N; Bordon, J M.
Afiliación
  • Sanchez GV; School of Public Health and Health Services, The George Washington University, Washington, DC, USA School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA.
  • Baird AM; School of Public Health and Health Services, The George Washington University, Washington, DC, USA School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA.
  • Karlowsky JA; Department of Medical Microbiology and Infectious Diseases, Faculty of Medicine, University of Manitoba, Winnipeg R3E 0J9, Canada.
  • Master RN; Quest Diagnostics Nichols Institute, Chantilly, VA, USA.
  • Bordon JM; Section of Infectious Diseases, Providence Hospital, Washington, DC, USA jbordon@provhosp.org.
J Antimicrob Chemother ; 69(12): 3259-62, 2014 Dec.
Article en En | MEDLINE | ID: mdl-25063776
OBJECTIVES: To examine the prevalence of multidrug-resistant (MDR) urinary Escherichia coli among US outpatients and to assess the antimicrobial activity of oral antibiotics commonly used to treat urinary tract infections (UTIs) against MDR isolates. METHODS: Antimicrobial susceptibility testing data from outpatient urine cultures in The Surveillance Network (TSN) Database USA were analysed. Six antimicrobial agents from six separate drug classes were included: ampicillin, cefalotin, ciprofloxacin, nitrofurantoin, trimethoprim/sulfamethoxazole and amoxicillin/clavulanate. Isolates were categorized as resistant to one, two, three, four, five and six agents and compared for the years 2001 and 2010. Phenotypes of MDR isolates were assessed to determine antimicrobial activity of recommended therapy for UTIs. RESULTS: Prevalence of MDR E. coli increased from 9.1% in 2001 (n = 29,198) to 17.0% in 2010 (n = 32,742) (P < 0.0001). In isolates that demonstrated resistance to three, four or five antimicrobial agents in 2010, resistance to nitrofurantoin was observed in only 2.1%, 7.5% and 24.1% of isolates, respectively. Conversely, widespread resistance was observed for trimethoprim/sulfamethoxazole (62.6%, 88.6% and 97.9% for isolates resistant to three, four and five agents, respectively) and ciprofloxacin (48.9%, 84.3% and 98.2% for isolates resistant to three, four and five agents, respectively). CONCLUSIONS: Because of its consistent antimicrobial activity against MDR E. coli, nitrofurantoin remains a reliable first-line agent for the empirical treatment of acute uncomplicated cystitis.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones Urinarias / Farmacorresistencia Bacteriana Múltiple / Escherichia coli / Infecciones por Escherichia coli / Antibacterianos / Nitrofurantoína Tipo de estudio: Risk_factors_studies Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: J Antimicrob Chemother Año: 2014 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones Urinarias / Farmacorresistencia Bacteriana Múltiple / Escherichia coli / Infecciones por Escherichia coli / Antibacterianos / Nitrofurantoína Tipo de estudio: Risk_factors_studies Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: J Antimicrob Chemother Año: 2014 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido