Antimicrobial susceptibility of community-acquired uropathogens in northern Israel

In order to study the trends in resistance to first line antimicrobial agents, the susceptibility patterns of 8338 community urinary isolates collected during 1995 were compared with 6692 isolates from 1999. Our data shows that community-acquired Gram-negative uropathogens remained highly susceptible to ciprofloxacin, cefuroxime and amoxycillin/clavulanate with sensitivities of 94, 89 and 83% respectively. Nitrofurantoin was shown to be suitable (99% susceptibility rate) only for Escherichia coli urinary tract infections. Ampicillin, first generation cephalosporins and sulphamethoxazole/trimethoprim could no longer be considered first line drugs for empirical treatment of clinically evident urinary tract infection because of very high resistant rates. Ampicillin remained a good choice for urinary infections caused by enterococci, 98% of the strains being susceptible. It was found that 1.25% of the Gram-negative uropathogens isolated during 1999 were extended spectrum beta-lactamase producers which suggests that this plasmid-encoded trait is finding its way into the community.