Urinary tract infections in ambulatory patients: etiologies and antibioticsusceptibilities as a function of patient history

OBJECTIVE: The aim of this study was to explore the relationship between et iological Factors, bacterial isolates and Escherichia coli susceptibility t o antibiotics in ambulatory patients with urinary tract infection. PATIENTS AND METHODS: A prospective study was conducted in 13 private medic al laboratories in France in March 1998. Data were collected an 658 cases i nvolving 679 strains in ambulatory patients with urinary tract infections. Data on age, gender, catheter insertion within the 7 preceding days, and hi story of hospitalization, urinary infection and antibiotic treatment during the 6 preceding months were recorded. The distribution of the bacterial is olates and Eschericha coil sensitivity to ciprofloxacin, cotrimoxazole, and gentamycin were studied. RESULTS: E. coil was most frequently isolated in women, in patients with no catheter or without a history of antibiotic treatment hospitalization or u rinary infection. There was no difference in E. coil sensitivity according to sex and age in women. In patients with prior antibiotic treatment all th e rested antibiotics except gentamycin were significantly less active. In c ase of prior hospitalization, the E coil isolates were more resistant to am oxicillin, quinolones, cotrimoxazole and gentamycin. The level of E. coli s uceptibility rose as the delay since hospitalization or urinary infection i ncreased. CONCLUSION: Ambulatory patients comprise a heterogeneous population requiri ng particular attention to correctly adapt therapeutic strategies.