Community-acquired Urinary Tract Infections: Treatment, Outcomes, and Antimicrobial Resistance
Abstract
Community-acquired urinary tract infections (CA-UTI) are common in young women. Reports of increasing resistance to the antimicrobial drugs commonly prescribed to treat CA-UTI, evidence of wide-spread dissemination of strains of multi-drug resistant i that can cause community outbreaks and expanding appreciation of the importance of the rational use of antibiotics are challenging the traditional management of this disease. Two population-based studies were performed to investigate the epidemiological features of CA-UTI with an emphasis on the antimicrobial resistance of causative bacteria. An eight-year retrospective cohort study was conducted in a large health maintenance organization to identify changes in uropathogen etiology and antimicrobial resistance and in empirical antimicrobial treatment practices and outcomes. A cross-sectional study was performed in a university population to investigate the relationship between changes in the prevalence of genotype-based clonal groups of uropathogen E. coli and the prevalence of antimicrobial resistance. From 1998 through 2005, less than 20% of the Escherichia coli causing uncomplicated CA-UTI (UCA-UTI) were resistant to the first line empirical treatment antimicrobial, trimethoprim/sulfamethoxazole (TMP/SMX). No trends were detected in the proportions of Escherichia coli that were resistant to TMP/SMX or to nitrofurantoin. In contrast, a small but steady increase in the proportion of Escherichia coli that were resistant to…
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Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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