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Clinical pharmacy and clinical trials (including case series)
Antimicrobial resistance of urinary Escherichia coli isolates
  1. C. Micu,
  2. A.F. Rosu,
  3. A. Bita,
  4. D. Calina,
  5. L. Rosu,
  6. O. Zlatian,
  7. A. Brumar
  1. 1University of Medicine and Pharmacy, Student, Craiova, Romania
  2. 2University of Medicine and Pharmacy, Clinical pharmacy, Craiova, Romania
  3. 3University of Medicine and Pharmacy, Microbiology, Craiova, Romania

Abstract

Background Escherichia coli is the most common bacteria involved in the aetiology of the urinary tract infections (UTI).

Purpose The aim of the study is to compare the susceptibility to antibacterial agents of Escherichia coli strains isolated from adults and children.

Materials and methods The study was conducted between 1.01.2009-31.12.2010 on 192 patients divided in two groups. Group A-72 hospitalised children under 15 years with clinical signs of UTI. Group B – 120 adult outpatients who had presented various conditions of the reno-urinary tract.

Urine samples were investigated using biochemical and microbiological (urine culture) methods. The authors used culture media to isolate specific bacterial species, whose identification was performed with API 20 E galleries. The antibiotic susceptibility test was performed on Mueller Hinton agar plates using the Kirby-Bauer disc diffusion method, according to NCCLS / CLSI – 2009 guidelines.

Results The morbidity by UTIs in children was 40.90%, mostly in girls (54.4%), in the age group of 1-3 years (43.91%) and infants (37.16%). The isolated E. coli strains (65.2%) were resistant to Ampicillin (65.14%), Ciprofloxacin (30.12%), Cefuroxime (26.18%) and Nalidixic acid (14.92%).

In adults the prevalence of UTIs was 43.33%, the infections were more common in women and in patients over 60 years. The isolated E. coli strains (55.77%) were resistant to Ampicillin (74.25%), Cefuroxime (39.29%), Ciprofloxacin (27.59%) and Nalidixic acid (24.14%). There was a significant difference in antibiotic resistance of the strains isolated from the two patient categories (Student's T test, p=0.0168).

Conclusions The tested strains of Escherichia coli involved in UTIs in adults had a higher resistance to antibiotics, compared with those isolated from children. It is recommended that the neonatologists, paediatricians and family physicians initiate therapy for these infections only after antibiotic susceptibility tests, in order to prevent selection of multidrug-resistant strains.

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