The bacterial profile and antibiotic resistance in acute uncomplicated urinary tract infection of females

Abstract

Objective: To determine the bacterial profile and antibiotic resistance in acute uncomplicated urinary tract infection (UTI) of females presenting in a family practice.

Setting: A solo family practice near the Cape Town city center.

Design: Prospective descriptive study.

Methods: Urine samples from all consecutive female cases of clinically suspected UTI with microscopic bacteriuria were examined with bacterial cultures and antibiotic sensitivity testing to amoxicillin, cotrimoxazole, nitrofurantoin, nalidixic acid, amoxicillin/clavulanic acid, norfloxacin, and cefaclor.

Results: Of the 49 positive cultures (growths > 100 000 per ml), 37 (76%, 95% CI 64%–88%) were due to Escherichia (E.) coli and 10 (20%, 95% CI 9% to 31%) Staphylococcus (S.) saprophyticus. Twenty-one (56.8%, 95% CI 39.5% to 72.8%) E. coli cultures were resistant to amoxicillin, while 18 (48.6%, 95% CI 31.9% to 65.6%) were resistant to cotrimoxazole. A 100% (95% CI 69% to 100%) of S. saprophyticus cultures were resistant to nalidixic acid.

Conclusions: E. coli is the most prevalent organism cultured in acute uncomplicated UTI of females in this family practice setting. Amoxicillin, cotrimoxazole, and nalidixic acid are not appropriate first line therapy due to antibiotic resistance.