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Transferable antibiotic resistance in enterobacteriaceae isolated from urinary tract infections in general practice
Abstract:
138 different coliform isolates from patients with UTI in 2 General Practices in Stockport, England, showed an incidence of drug resistance of 36%: 47% of these strains transferred resistance to E. coli K12. Multiple resistance, i.e. resistance to more than 2 drugs occurred in more than a quarter of resistant isolates and sulphonamide resistance was most common. More than twice as many strains in this series (1973--74) were sulphonamide resistant compared with a previous survey (1968--70). MIC values of R+ resistant isolates were much higher with sulphonamide resistant strains than the probable urine levels during therapy, but the situation with ampicillin and tetracycline levels was variable.
Insights
A study of 138 coliform isolates from urinary tract infections (UTI) found 36% drug resistance, with sulphonamide resistance increasing over time. Resistance transfer was common, and multiple drug resistance was observed in over a quarter of resistant strains.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Urinary tract infections (UTI) are common, often caused by coliform bacteria.
- Antimicrobial resistance in UTI pathogens is a growing public health concern.
- Understanding resistance patterns is crucial for effective treatment strategies.
Purpose of the Study:
- To investigate the prevalence and patterns of drug resistance in coliform isolates from UTI patients.
- To assess the transferability of drug resistance among bacterial strains.
- To compare current resistance levels with historical data.
Main Methods:
- Collection of 138 coliform isolates from UTI patients across two general practices.
- Phenotypic testing for drug resistance to various antimicrobial agents.
- Assessment of resistance transfer to Escherichia coli K12.
- Comparison of resistance data with a previous survey (1968-1970).
Main Results:
- An overall drug resistance incidence of 36% was observed in the coliform isolates.
- Resistance transfer to E. coli K12 occurred in 47% of resistant strains.
- Multiple drug resistance (resistance to >2 drugs) was present in over 25% of resistant isolates.
- Sulphonamide resistance showed a significant increase compared to a previous survey.
- Minimum inhibitory concentration (MIC) values for sulphonamide-resistant strains exceeded probable therapeutic urine levels.
Conclusions:
- Coliform isolates from UTI exhibit significant drug resistance, including transferable resistance.
- The prevalence of sulphonamide resistance has markedly increased, posing a therapeutic challenge.
- High MIC values for certain resistant strains suggest potential treatment failures with standard antimicrobial therapy.