Journal Article

Prevalence and Predictors of Trimethoprim-Sulfamethoxazole Resistance among Uropathogenic <i>Escherichia coli</i> Isolates in Michigan

Patricia D. Brown, Alison Freeman and Betsy Foxman

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 34, issue 8, pages 1061-1066
Published in print April 2002 | ISSN: 1058-4838
Published online April 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/339491
Prevalence and Predictors of Trimethoprim-Sulfamethoxazole Resistance among Uropathogenic Escherichia coli Isolates in Michigan

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Resistance among uropathogenic Escherichia coli to trimethoprim-sulfamethoxazole (TMP-SMX) has increased. Risk factors for resistance and the impact on clinical failure have been poorly described. We performed a retrospective cohort study of women with acute uncomplicated cystitis seen at a university health center and at primary care clinics in southeastern Michigan from 1992 to 1999. The prevalence of TMP-SMX resistance increased from 8.1% to 15.8% (P = .01). Women who had taken TMP-SMX recently were >16 times as likely as women who had not taken antibiotics recently to be infected with an isolate resistant to this agent; those who had taken any other antibiotic were more than twice as likely to be infected with a resistant isolate. Women infected with a TMP-SMX–resistant isolate who were treated with TMP-SMX were >17 times as likely to have treatment failure. Recent antibiotic use is a risk factor for infection with a TMP-SMX–resistant isolate; patients who are infected with a TMP-SMX–resistant isolate and who are treated with this agent are at a higher risk for clinical failure.

Journal Article.  3980 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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