270. Resistance to common antimicrobial agents among E. coli isolates from acute uncomplicated cystitis in Seattle, 1998-2010
Session: Poster Abstract Session: Antimicrobial Susceptibility and Resistance
Friday, October 21, 2011
Room: Poster Hall B1

Background: Increasing evidence suggests that routine treatment of common outpatient infections such as acute uncomplicated cystitis (AUC) contributes to the development of antimicrobial resistance. Per IDSA guidelines, benchmark community E. coli resistance rates indicating altering empiric therapeutic choices are 20% for trimethoprim-sulfamethoxazole (T-S) and 10% for ciprofloxacin (CF). However, since community acquired AUC is not reportable, temporal trends in E. coli antimicrobial resistance are difficult to track. Through studies conducted in the UTI Research Clinic in Seattle, we collected and analyzed longitudinal data on rates of resistance to common antimicrobials for uropathogenic E. coli in a county STD clinic (STD) and the Hall Health Primary Care Center (HHPCC), a university based student health clinic, from 1998-2010.

Methods: Using standard methods, urine culture and sensitivity were performed on 1,772 consecutive urine specimens collected from women enrolled in 9 different UTI studies at HHPCC and 854 consecutive urine specimens collected from men and women attending an STD clinic and suspected of having a UTI syndrome based on provider clinical judgment. T-S or NF is first line therapy for HHPCC, whereas therapy is per provider choice at STD.

Results: E. coli resistance rates for T-S have exceeded IDSA guideline benchmark rates since 2004 among isolates from STD and have gradually increased to approaching 20% among HHPCC isolates. For CP, although E. coli resistance rates have gradually increased, resistance currently remains below 10% in both settings.


                        HHPCC                                                STD

Conclusion: These data support concerns regarding rising antimicrobial resistance rates for common, community acquired infections. NF remains an active against E. coli collected from patients with AUC, supporting its use as a first line for AUC, as suggested by the IDSA guidelines.

Subject Category: C. Clinical studies of bacterial infections and antibacterials including sexually transmitted diseases and mycobacterial infections (surveys, epidemiology, and clinical trials)

Ann Stapleton, MD1, Marsha Cox, MS1, Amanda White, BS1 and Thomas Hooton, MD, FIDSA2, (1)University of Washington, Seattle, WA, (2)Medicine, University of Miami, Miami, FL


A. Stapleton, None

M. Cox, None

A. White, None

T. Hooton, None

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