Antimicrobial Resistance of Uncomplicated Urinary Tract Infections in Northern Utah

Abstract

OBJECTIVE: To evaluate antimicrobial resistance in uropathogenic bacteria in northern Utah.

DESIGN: One hundred twenty bacterial isolates from community-acquired UTI in the northern Utah area (Davis and Weber Counties) were tested. Samples were taken from otherwise healthy women, ages 18 to 50. Antimicrobial susceptibility testing for sulfamethoxazole/trimethoprim (SXT/TMP), ciprofloxacin, and nitrofurantoin comprised the process.

SETTING: The Clinical Laboratory Science Department at Weber State University, with samples coming from clinics in the northern Utah area (Davis and Weber Counties).

PARTICIPANTS: Urine samples were taken from otherwise healthy women, ages 18 to 50, who suffered from uncomplicated urinary tract infections.

MAIN OUTCOME MEASURE: Antimicrobial resistance was measured using antimicrobial susceptibility testing and shown with other national resistance rates.

RESULTS: Of bacterial isolates, 21.3% were resistant to SXT/TMP, 14.4% were resistant to ciprofloxacin, and 13.9% were resistant to nitrofurantoin. The resistance rates for ciprofloxacin and nitrofurantoin were acceptable for empirical UTI treatment (< 20% resistance), but local bacterial populations were found to demonstrate an increase in resistance to these two drugs as compared to previously observed national data. SXT/TMP resistance was above the recommended resistance threshold of 20% for effective empirical treatment, as advised by the IDSA.

CONCLUSION: Results suggest that uncomplicated community-acquired UTI be treated with nitrofurantoin. Other recommendations include continued monitoring of local uropathogenic antimicrobial resistance.

ABBREVIATIONS: ATCC = American Type Culture Collection; IDSA = Infectious Disease Society of America; NCCLS = National Committee for Clinical Laboratory Standards; SXT/TMP = sulfamethoxazole/trimethoprim; UTI = urinary tract infections.