JAC Advance Access originally published online on June 14, 2006
Journal of Antimicrobial Chemotherapy 2006 58(2):344-348; doi:10.1093/jac/dkl243
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Antibiotic resistance of coliform organisms from community-acquired urinary tract infections in Zenica-Doboj Canton, Bosnia and Herzegovina
Laboratory for Clinical and Sanitary Microbiology, Cantonal Public Health Institution Zenica Fra Ivana Jukica 2/4, 72000 Zenica, Bosnia and Herzegovina
Received 11 June 2005; returned 18 October 2005; revised 19 April 2006; accepted 18 May 2006
*Corresponding author. Tel: 00-387-32-443-580; Fax: 00-387-32-443-530; E-mail: selma_kamb{at}yahoo.com
Objectives: To collect routine susceptibility data for coliforms isolated from patients with community-acquired urinary tract infections (UTIs) in Zenica-Doboj Canton, Bosnia and Herzegovina and to relate them to bacterial identification and patient demographics with a view to guiding empirical therapy.
Methods: During 1998–2001, 54 638 consecutive urine samples were analysed by standard procedures. Antimicrobial susceptibility testing for 15 antimicrobials was performed by the disc diffusion method.
Results: A total of 10 765 Escherichia coli and other coliforms were isolated, of which 5043 (46.8%) were duplicates. Resistance rates were significantly higher in duplicate isolates for almost all antibiotics tested (P < 0.05), except for ampicillin, cefazolin, aztreonam and co-trimoxazole. Inclusion of coliforms other than E. coli (25.8%) significantly increased resistance rates for all tested antibiotics (P < 0.001) except imipenem. Overall coliform resistance rates were significantly higher in males than in females (P < 0.001).
Conclusions: Due to high ampicillin and trimethoprim/sulfamethoxazole resistance rates for all subsets analysed it is highly recommended to perform urinalysis and antibiotic susceptibility testing in all patients, except in the age group 0–6 years of male patients and in the age group 20–64 years of female patients, in which empirical therapy with these antibiotics can be applied. Nitrofurantoin should also be considered as the first-line therapy, especially in children. It is important for physicians to know susceptibility data for UTIs in order to optimize the use of empirical therapy.
Keywords: Escherichia coli , susceptibility testing , surveillance