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Resistance to trimethoprim among urinary tract isolates in the United Kingdom

K J Towner

    Reviews of Infectious Diseases
    |March 1, 1982
    PubMed

    Insights

    Urinary tract infections show increasing resistance to trimethoprim (TMP) due to plasmid and transposon spread. This trend necessitates ongoing monitoring of TMP and sulfonamide resistance in enterobacteria.

    Area of Science:

    • Microbiology
    • Antimicrobial Resistance

    Background:

    • Sequential surveys conducted from 1978 to 1980 in Nottingham, UK.
    • Focus on enterobacteria isolated from urinary tract infections.
    • Observed an increasing trend in trimethoprim (TMP) resistance.

    Purpose of the Study:

    • To document the trend of TMP resistance in urinary tract pathogens.
    • To investigate the mechanisms contributing to increased TMP resistance.
    • To highlight the implications for clinical treatment and future monitoring.

    Main Methods:

    • Surveillance of antimicrobial resistance patterns.
    • Analysis of resistance trends in both hospital and community settings.
    • Identification of resistance mechanisms, including plasmids and transposons.

    Main Results:

    • A significant upward trend in TMP resistance was observed between 1978 and 1980.
    • Accelerated spread of TMP resistance plasmids and transposons identified as a major factor.
    • Emergence of chromosomally located TMP resistance mediated by transposons.

    Conclusions:

    • The increasing TMP resistance raises concerns about treatment efficacy for urinary tract infections.
    • The stability of chromosomally mediated resistance is a significant concern.
    • Continued monitoring of TMP and sulfonamide resistance is crucial, especially with increasing TMP monotherapy use.

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