Medicus, Vol. 15 No. 2_UG infekcije, 2006.
Review article
Antibiotic Resistance of Causative Agents of Urogenital Infections
Saša Andrašević
Arjana Tambić Andrašević
Abstract
The choice of an antibiotic to treat urogenital
infections (UGI) used to be easy. However, antibiotic resistance
of uropathogens has become an increasing problem because
of antibiotic overuse. In Croatia, 50% of E. coli and 30% of P.
mirabilis isolates are resistant to ampicillin, and the rate of
extended spectrum beta-lactamase (“ESBL”) producing E. coli
is approx. 2%. Due to an excellent rate of bacterial eradication
from the urogenital tract, co-trimoxazole is a valuable therapeutic
option in the treatment of urinary tract infections (UTI).
However, the resistance rate of E. coli to this drug has exceeded
20% in many parts of the world, including Croatia, thus putting
the co-trimoxazole role in the empiric therapy of UTI into question.
In Europe, the resistance of E. coli to quinolones has been
constantly increasing, and resistance rates in Croatia have reached
10%. Tetracyclines, macrolides and some quinolones have
good activity against mycoplasma, ureaplasma and chlamydia.
Resistance in these pathogens has been described, but has not
yet reached clinical signifi cance. Resistance to penicillin and
tetracycline in gonococci is high in some parts of the world, and
resistance to quinolones is increasing. Recent use of antibiotics,
recent hospitalization, use of corticosteroids, diabetes, chronic
neurologic or urologic disease, residence in a home for elderly
and disabled, and recent travel to the areas with known high
resistance rates are all considered as predisposing factors for
acquiring infection with a multiresistant organism. As the onset
of treatment of most urogenital infections is empirical, risk factors
along with prevalence and antibiotic sensitivity patterns of
uropathogens, both on national and international level, should
be well known. The most reliable and up-to-date antibiotic resistance
data could be obtained from the European Antimicrobial
Resistance Surveillance System (EARSS). For Croatia, they could
be also obtained from the Croatian Committee for Antibiotic
Resistance Surveillance of the Croatian Academy of Medical
Sciences that collects data from 30 centers in Croatia.
Keywords
urogenital infections; causative agents; resistance rates
Hrčak ID:
18149
URI
Publication date:
29.12.2006.
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