JAC Advance Access published online on November 28, 2002
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg028
© 2002 by The British Society for Antimicrobial Chemotherapy
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Original Paper
1 Department of Clinical Microbiology, Central Hospital, SE-351
85 Växjö, Sweden
* Corresponding author. E-mail: gunnar.kahlmeter{at}ltkronoberg.se.
Received 11 March 2002
; revised 20 June 2002
; accepted 3 October 2002
The ECO·SENS study is the first international
survey to investigate the prevalence and susceptibility of pathogens
causing community-acquired acute uncomplicated urinary tract infections
(UTIs). Midstream urine samples were taken for culture and for testing
for the presence of leucocytes from 4734 women not older than 65
years presenting with symptoms of acute UTI at 252 community health
care centres in 17 countries. Recognized urinary tract pathogens were
identified and the susceptibility to 12 antimicrobials determined.
Pathogens were present in 3278 (69.2%) patients, Escherichia
coli accounting for 77.0% of isolates. In E.
coli, 42% of the isolates were resistant to one or
more of the 12 antimicrobial drugs investigated. Resistance was most
common to ampicillin (29.8%) and sulfamethoxazole (29.1%),
followed by trimethoprim (14.8%), trimethoprim/sulfamethoxazole
(14.1%) and nalidixic acid (5.4%). Resistance
in E. coli to co-amoxiclav, mecillinam, cefadroxil,
nitrofurantoin, fosfomycin, gentamicin and ciprofloxacin was <3%.
However, co-amoxiclav resistance was apparent in Portugal (9.3%)
as was resistance to the quinolones, nalidixic acid and ciprofloxacin,
in Portugal (11.6% and 5.8%, respectively) and
Spain (26.7% and 14.7%, respectively). Overall, Proteus mirabilis were less resistant to ampicillin
(16.1%) and more resistant to trimethoprim (25.5%)
than E. coli, whereas Klebsiella spp.
were more resistant to ampicillin (83.5%) and fosfomycin
(56.7%). ‘Other Enterobacteriaceae' were
more resistant to the broad spectrum
An international survey of the antimicrobial susceptibility
of pathogens from uncomplicated urinary tract infections: the ECO·SENS
Project
-lactams
(ampicillin 45.9%, co-amoxiclav 21.3% and
cefadroxil 24.6%), nitrofurantoin (40.2%) and
fosfomycin (15.6%). In Staphylococcus saprophyticus resistance
development was rare. Overall, antimicrobial resistance was lowest
in the Nordic countries and Austria and highest in Portugal and
Spain.
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