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JAC Advance Access published online on June 14, 2006
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkl243
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Received June 11, 2005
Revised April 19, 2006
Accepted May 18, 2006

Original article

Antibiotic resistance of coliform organisms from community-acquired urinary tract infections in Zenica-Doboj Canton, Bosnia and Herzegovina

Selma Uzunovic-Kamberovic 1 *

1 Laboratory for Clinical and Sanitary Microbiology, Cantonal Public Health Institution Zenica, Fra Ivana Jukica 2/4, 72000 Zenica, Bosnia and Herzegovina

* To whom correspondence should be addressed.
Selma Uzunovic-Kamberovic, E-mail: selma_kamb{at}yahoo.com


  Abstract

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.
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