The prevalence of antimicrobial resistance among uropathogens causing acute uncomplicated cystitis in young women

Four hundred and fifty-two urine isolates from women with acute uncomplicat ed cystitis and a positive urine culture presenting to a sexually transmitt ed disease clinic were collected during 1989-1991, and 213 specimens were c ollected over 1995-1997. The predominant species was Escherichia coli, repr esenting 68% of the isolates; others included Staphylococcus saprophyticus (8%), Group B streptococci (7%), Proteus spp. (6%), Klebsiella spp. (4%) an d Enterococcus spp. (3%). More than 10% of the E. coli isolates were resist ant to ampicillin, cephalothin, tetracycline and trimethoprim-sulfamethoxaz ole (TMP-SMX) during both study periods, with the greatest increase in resi stance to ampicillin and TMP/SMX between the two periods. Six hundred and f our urinary tract infection isolates, including 83% E. coli, 7% S. saprophy ticus, 3% Klebsiella spp. 2% Proteus spp., 2% enterococci, 1% Enterobacter spp. and 2% other organisms, were collected from women with acute cystitis attending a university student health service during 1995. Among E. coli is olates, 25% were resistant to ampicillin, 24% to tetracycline and 11% to TM P-SMX. Resistance to fluoroquinolones was essentially absent among gram-neg ative pathogens. Continued evaluation of susceptibility patterns of pathoge ns causing acute uncomplicated cystitis to traditional as well as new antim icrobials in well defined populations is necessary to ascertain the optimal empiric therapy. (C) 1999 Elsevier Science B.V. All rights reserved.