Surveillance of antimicrobial resistance patterns and data for urinary tract pathogens in the USA

Monitoring of bacterial resistance patterns provides information needed for developing treatment guidelines, directing public health measures, and pre scribing appropriate therapy for bacterial infections. Standardisation of l aboratory methodology and data analysis is necessary. In the USA, several r ecently published reports highlight increasing rates of resistance to cotri moxazole (trimethoprim-sulfamethoxazole) among Escherichia coli isolated fr om urine. These reports have been confirmed by results from the electronic resistance surveillance network (The Surveillance Network, TSN (TM) Databas e-USA), which collects data from more than 200 hospital laboratories locate d across the USA. TSN (TM) Database-USA found 18% resistance to cotrimoxazo le among 131 845 E. coli isolate results collected in 1998. However, levels of resistance to ciprofloxacin remain low (2.3%). When an E. coli strain i s resistant to ciprofloxacin. it is usually also resistant to one or more o ther antibacterial agents. More complex studies of bacterial resistance are needed in order to answer questions regarding mechanisms of resistance dev elopment, impact of drug usage, and effect of resistance on clinical outcom e.