Resistance among urinary tract pathogens experience - Outside the USA

Comparison of bacterial resistance rates across different countries (e.g. in Europe) is difficult because of variation in laboratory methodology and interpretation of results. Although urinary tract infection is one of the most common reasons for adults to seek medical consultation, data regarding resistance among urinary tract isolates are limited and often reports are based on results from a single centre. However, certain trends outside the USA are becoming evident. Reported rates of resistance to amoxicillin or ampicillin among Escherichia coli strains responsible for urinary tract infections are approaching 50% in the UK, 30% in Finland, 40% in Germany and France, and 70% in Spain. Resistance rates to trimethoprim or cotrimoxazole (trimethoprim/sulfamethoxazole) have been reported to be in the region of 20% in the UK, Finland and France, 30% in Germany and >40% in Spain. Resistance to fluoroquinolones has been reported to be <5% in Finland and France, 10% or less in the UK and Germany, and >20% in Spain. In Japan, the MIC80 values of representative fluoroquinolones, fourth-generation cephalosporins and carbapenems against E. roll urinary strains isolated from outpatients increased over a 3-year period. Rates of resistance to aminopenicillins and cotrimoxazole are very high in Latin America, and >10% resistance to ciprofloxacin has been reported in some countries in recent years. Ongoing monitoring of resistance trends is vital. Cooperative efforts will identify trends and the experience of one country may help another.