Resistance among urinary tract pathogens experience - Outside the USA

Comparison of bacterial resistance rates across different countries (e.g. i n Europe) is difficult because of variation in laboratory methodology and i nterpretation of results. Although urinary tract infection is one of the mo st common reasons for adults to seek medical consultation, data regarding r esistance among urinary tract isolates are limited and often reports are ba sed on results from a single centre. However, certain trends outside the US A are becoming evident. Reported rates of resistance to amoxicillin or ampi cillin among Escherichia coli strains responsible for urinary tract infecti ons are approaching 50% in the UK, 30% in Finland, 40% in Germany and Franc e, and 70% in Spain. Resistance rates to trimethoprim or cotrimoxazole (tri methoprim/sulfamethoxazole) have been reported to be in the region of 20% i n the UK, Finland and France, 30% in Germany and >40% in Spain. Resistance to fluoroquinolones has been reported to be <5% in Finland and France, 10% or less in the UK and Germany, and >20% in Spain. In Japan, the MIC80 value s of representative fluoroquinolones, fourth-generation cephalosporins and carbapenems against E. roll urinary strains isolated from outpatients incre ased over a 3-year period. Rates of resistance to aminopenicillins and cotr imoxazole are very high in Latin America, and >10% resistance to ciprofloxa cin has been reported in some countries in recent years. Ongoing monitoring of resistance trends is vital. Cooperative efforts will identify trends an d the experience of one country may help another.