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increasing antibiotic resistance of urinary tract pathogens: a six-year follow-up of urine cultures in the community.

Background. Urinary tract infections (UTI) are among the most common bacterial infections worldwide.Primary care physicians often must treat patients with symptoms of UTI empirically, without urinalysis or urine culture. In this context, it is necessary to examine the changing bacterial environment in the community in order to chose appropriate antibiotics for optimal medical care. .

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increasing antibiotic resistance of urinary tract pathogens: a six-year follow-up of urine cultures in the community.

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    1. Increasing antibiotic resistance of urinary tract pathogens: A six-year follow-up of urine cultures in the community. Matalon A, Cohen H A, Kaplan H, Czitron B, Savyon M, Yaphe J and Weingarten M . Department of Family Medicine, Sackler Faculty of Medicine,Tel-Aviv University and Clalit Health Services, Dan Petach-Tikva District.

    3. Study questions What is the yield of urine cultures? What organisms are found? What is the rate of antibiotic resistance? How has this changed over the past 6 years?

    4. Methods Retrospective review of: the type of bacteria present bacterial antibiotic resistance All urine culture tests ordered in the month of January in the years 1993 to 1996. All tests sent to a central laboratory serving about 160,000 persons in Central Israel. Follow-up study using the same method in January 1999.

    5. Results 18,484 urine cultures evaluated 2746 cultures/month January 1993-96 7500 cultures/month in January 1999. Positive cultures in 16.7%. E.coli in 72.8% of positive cultures. Amoxycillin: E.coli, Proteus and Klebsiella showed almost 100% resistance Cotrimoxazole: 50% resistance Quinolones: Rising to 10% for E.coli and Klebsiella and to 40% for Proteus.

    6. E.coli resistant to antibiotics

    7. Conclusions Amoxycillin is no longer the drug of first choice for the empirical antibiotic treatment of community-acquired UTI in central Israel. The role of cotrimoxazole is changing. Resistance to quinolones is an emerging problem

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