Resistance of bacteria in urinary tract infections

Bacterial infection of the urinary tract is a common health problem in youn g women but also the most common nosocomial infection (> 33%) contributing to the mortality of patients, and increasing the duration and cost of hospi talization. Escherichia coli is the most predominant organism and its preva lence varies in different studies. The high consumption of inappropriately prescribed antibiotics, combined with multiple pathology and frequent use o f invasive devices, is a major factor contributing to high levels of resist ance. There is a serious decrease in susceptibility of E. coli strains to a moxycillin, due to the presence of R-TEM enzymes, to cotrimoxazole and trim ethoprim. Nitrofurantoin and fosfomycin-trometamol remain highly active aga inst urinary Enterobacteriaceae, with over 90% of E. coli being susceptible . Knowledge of the most likely causative organisms and the prevalence of re sistance pathogens to antimicrobial agents is essential to select antibioti cs and to establish guidelines for the empirical treatment of urinary tract infections. (C) 2000 Elsevier Science B.V. and International Society of Ch emotherapy. All rights reserved.