Cent Eur J Public Health 2019, 27(3):245-250 | DOI: 10.21101/cejph.a4833

Antimicrobial susceptibility among urinary Escherichia coli isolates from female outpatients: age-related differences

Zorana Djordjević¹, Marko Folić^2,3, Violeta Ninković⁴, Dragan Vasiljević^3,4, Slobodan Janković^2,3

¹ Department of Hospital Infections Control, Clinical Centrе Kragujevac, Kragujevac, Serbia

² Clinical Pharmacology Department, Clinical Centrе Kragujevac, Kragujevac, Serbia

³ Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia

⁴ Public Health Institute Kragujevac, Kragujevac, Serbia

Objectives: Urinary tract infections (UTIs) are common problems in women, and important reason for visiting primary care physicians, resulting in substantial financial burden to community. The aim of this study was to determine the resistance rates of E. coli to commonly prescribed antimicrobial drugs for community-acquired UTIs in women and to establish the association between age and resistance to antibiotics among isolates of E. coli from urine.

Methods: The study was designed as a retrospective cross-sectional study during the 5-years period. It was conducted on a sample of urinary tract isolates of E. coli taken from women with community-acquired UTIs. After prevalence of E. coli resistance to antibiotics was established, the analysis of risk factors for emergence of resistance was conducted.

Results: There were 10,734 isolates of E. coli, comprising 70.62% of all samples analyzed. E. coli was the most frequently resistant to ampicillin (54.68%), followed by trimethoprim-sulphamethoxazole (37.46%), first and second generation cephalosporins (cephalexin and cefaclor) (29.53% both), and ciprofloxacin (23.80%). Less than 50% of E. coli isolates was sensitive to all three tested antibiotics, and nearly 13% acquired triple-resistance. Prevalence of isolates resistant to two or three agents was higher in the subgroup of women older than 65 years.

Conclusions: Empirical choice of antimicrobial agent for community-acquired non-complicated UTIs in women should be individualized on the basis of the patient's age, prevalence of resistance in the local community, and compliance history of the patient.

Keywords: urinary tract infections, community acquired, E. coli, resistance, utilization

Received: May 12, 2016; Revised: July 19, 2019; Accepted: July 19, 2019; Published: September 30, 2019  Show citation