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Antimicrobial Agents and Chemotherapy, May 2001, p. 1402-1406, Vol. 45, No. 5
0066-4804/01/$04.00+0   DOI: 10.1128/AAC.45.5.1402-1406.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Multidrug-Resistant Urinary Tract Isolates of Escherichia coli: Prevalence and Patient Demographics in the United States in 2000

Daniel F. Sahm,1 Clyde Thornsberry,2 David C. Mayfield,1 Mark E. Jones,3 and James A. Karlowsky1,*

MRL, Herndon, Virginia 201711; MRL, Brentwood, Tennessee 370272; and MRL, 3554XD Utrecht, The Netherlands3

Received 14 December 2000/Returned for modification 24 January 2001/Accepted 9 February 2001

Concurrent resistance to antimicrobials of different structural classes has arisen in a multitude of bacterial species and may complicate the therapeutic management of infections, including those of the urinary tract. To assess the current breadth of multidrug resistance among urinary isolates of Escherichia coli, the most prevalent pathogen contributing to these infections, all pertinent results in The Surveillance Network Database---USA from 1 January to 30 September 2000 were analyzed. Results were available for 38,835 urinary isolates of E. coli that had been tested against ampicillin, cephalothin, ciprofloxacin, nitrofurantoin, and trimethoprim-sulfamethoxazole. Of these isolates, 7.1% (2,763 of 38,835) were resistant to three or more agents and considered multidrug resistant. Among the multidrug-resistant isolates, 97.8% were resistant to ampicillin, 92.8% were resistant to trimethoprim-sulfamethoxazole, 86.6% were resistant to cephalothin, 38.8% were resistant to ciprofloxacin, and 7.7% were resistant to nitrofurantoin. The predominant phenotype among multidrug-resistant isolates (57.9%; 1,600 of 2,793) included resistance to ampicillin, cephalothin, and trimethoprim-sulfamethoxazole. This was the most common phenotype regardless of patient age, gender, or inpatient-outpatient status and in eight of the nine U.S. Bureau of the Census regions. Rates of multidrug resistance were demonstrated to be higher among males (10.4%) than females (6.6%), among patients >65 years of age (8.7%) than patients <= 17 (6.8%) and 18 to 65 (6.1%) years of age, and among inpatients (7.6%) than outpatients (6.9%). Regionally, the rates ranged from 4.3% in the West North Central region to 9.2% in the West South Central region. Given the current prevalence of multidrug resistance among urinary tract isolates of E. coli in the United States (7.1%), continued local, regional, and national surveillance is warranted.

* Corresponding author. Mailing address: MRL, 13665 Dulles Technology Dr., Suite 200, Herndon, VA 20171-4603. Phone: (703) 480-2500. Fax: (703) 480-2670. E-mail: jkarlowsky{at}mrlinfo.com.

Antimicrobial Agents and Chemotherapy, May 2001, p. 1402-1406, Vol. 45, No. 5
0066-4804/01/$04.00+0   DOI: 10.1128/AAC.45.5.1402-1406.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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