[Spectrum of pathogens and resistance to antibiotics in urinary tract infections and the consequences for antibiotic treatment: study of urology inpatients with urinary tract infections (1994-2001)]

Abstract

From 1994 to 2001 all uropathogens of urology inpatients were identified and the sensitivity to 14 antibiotics was tested [trimethoprim (TMP)/sulfamethoxazole (SMZ), ciprofloxacin, ampicillin, mezlocillin, ampicillin/sulbactam, piperacillin/tazobactam, cefuroxime, cefpodoxime, cefotaxime, ceftazidime, gentamicin, penicillin, oxacillin, and vancomycin]. The following results were obtained: 1. No general trend toward an increase in resistance was noted during the observation period except for E. coli resistance to TMP/SMZ (25.1% in 2000) and ciprofloxacin (10.4% in 2000). 2. Vancomycin-intermediary staphylococci or vancomycin-resistant enterococci played no role. 3. The lowest resistance to all pathogens was found for piperacillin/tazobactam (8.4% in 2001); carbapenems were not tested. 4. If uropathogens are stratified into gram-positive and gram-negative bacteria, for oral administration, ciprofloxacin is the antibiotic with the lowest resistance rate for urinary tract infections with gram-negative pathogens and ampicillin/sulbactam for gram-positive pathogens. 5. Subsequent to further differentiation of the pathogens with simple tests that can be performed after overnight incubation of the culture, empirical antibiotic therapy can then be effectively employed. To draw the correct conclusions from these data, the urologist must either be personally involved in the analytical procedure or receive the interim results promptly.