CLINICAL-SIGNIFICANCE AND SPREAD OF FLUOROQUINOLONE RESISTANT UROPATHOGENS IN HOSPITALIZED UROLOGICAL PATIENTS

The minimum inhibitory concentrations (MIC) of ciprofloxacin were dete rmined for 441 uropathogens from patients with complicated and/or hosp ital acquired urinary tract infections (UTI). None of the Enterobacter iaceae was resistant (MIC greater than or equal to 4 mg/l), but 21.7% of enterococci, 28.3% of Pseudomonas spp. and 38.5% of staphylococci w ere. Subtyping of the strains revealed that with staphylococci there w as no clonal spread of resistant strains. In the case of enterococci a nd Pseudomonas spp., however, cross infections played a major role (46 % and 40% respectively). In a retrospective analysis of 370 UTI episod es caused by Pseudomonas aeruginosa (74), enterococci (185) or staphyl ococci (111) there was no difference between sensitive and resistant s trains with respect to clinical aspects and rates of elimination by ap propriate anti-bacterial therapy The rates of spontaneous disappearanc e without antibacterial therapy ranged from 28% in the case of P. aeru ginosa up to 63% in the case of coagulase-negative staphylococci. This implies that especially in Un caused by gram-positive cocci an indica tion for antibacterial therapy should be weighted thoroughly and fluor oquinolones should only be used in accordance with sensitivity testing .