Antimicrobial resistance among uropathogens that cause community-acquired urinary tract infections in women: A nationwide analysis

Current recommendations for empirical therapy for community-acquired urinar y tract infection (UTI) in women hinge on knowledge of antimicrobial suscep tibility patterns in the geographic region of the practitioner. We conducte d a survey of antimicrobial susceptibilities of 103,223 isolates recovered from urine samples that were obtained in 1998 from female outpatients natio nally and within 9 geographic regions in the United States. Resistance of E scherichia coli isolates to trimethoprim-sulfamethoxazole varied significan tly according to geographic region, ranging from a high of 22% in the weste rn United States to a low of 10% in the Northeast (P < .001). There were no clinically significant age-related differences in the susceptibility of E. coli to any of the study drugs, but the susceptibility to fluoroquinolones of non-E. coli isolates that were recovered from women who were aged >50 y ears was significantly lower than that of isolates recovered from younger w omen (P < .001). The in vitro susceptibility of uropathogens in female outp atients varies according to age and geographic region.