Antimicrobial Resistance of Urinary Tract Isolates in Acute Uncomplicated Cystitis Among College-Aged Women: Choosing a First-Line Therapy

Abstract

Objective and Participants The authors of this retrospective case study focused on antimicrobial susceptibility of urinary tract isolates in cases of acute uncomplicated cystitis in college-aged women, aged 18 to 24 years, diagnosed at a major south-central university student health center. Methods The authors obtained pertinent data from patient medical and laboratory records, including, diagnoses, urine culture, and susceptibility results. Results Of 179 isolates, 161 (90%) were Escherichia coli (E. Coli) isolates, of which 23% were resistant to trimethoprimsulfamethoxazole, < 1% were resistant to Ciprofloxacin, and < 1% were resistant to nitrofurantoin. Sixty-eight (42%) E. Coli isolates were multidrug resistant. There were 18 isolates cultured in the study group that were significant organisms other than E. coli. For all organisms in the study group, there was a combined resistance rate of 22% to trimethoprim-sulfamethoxazole, < 1.0% for Ciprofloxacin, and 7% for nitrofurantoin. Conclusions The findings suggest that both Ciprofloxacin and Nitrofurantoin are acceptable choices for empiric therapy of acute uncomplicated urinary tract infection in this study population, keeping in mind the potential for rising resistance rates to Ciprofloxacin in the community setting.

Keywords:

• college health
• fluoroquinolones
• resistance
• urinary tract infection