| Abstrakt: |
The structure and sensitivity of the agents of community-aquired urinary infections (CUI) in Moscow were studied in a prospective clinicomicrobiological trial carried out in 2005 with participation of 8 Moscow outpatient clinics. Minimal inhibitory concentration (MIC) of antimicrobial drugs was estimated using agar dilution test according to NCCLS recommendations (2000-2002). Acute and chronic cystitis, chronic pyelonephritis and acute pyelonephritis were most frequent CUI (49.1, 39.8 and 5.3%, respectively, while among complicating factors most frequently occurred urolithiasis (48.5%), diabetes mellitus (24.2%), renal cysts (7.6%), infravesical obstruction (6,1%). CUI in Moscow were primarily caused by E.coli (72.5%). Compared to complicated CUI, uncomplicated ones were characterized by less frequent E. coli isolation (53 and 80.9%, respectively), but significantly more frequent isolation of P.aeruginosa (4.5 and 0%) and E. faecalis (9.1 and 4.2% isolation. High resistance of E.coli isolated from patients with uncomplicated CUI was seen to cotrimoxasol (28.7%) and ampicillin (39.1%), low resistance--to amoxicilline/ clavulanate (6.3%), fluoroquinolones (6.3%), nitrofurantoin (0%), cefuroxime (6.3%), cefotaxime (0%), phosphomicine (0%). Patients with complicated CUI compared to uncomplicated CUI significantly more often had E.coli strains nonsensitive to amoxicilline/clavulanate (14 and 6.3%), cotrimoxasol (25.6 and 18.8%), nalidixic acid (18.6 and 6.3%, respectively). Polyresistant E. coli strains were significantly more prevalent in complicated CUI than in uncomplicated CUI (45.4 and 25.1%, respectively). Thus, E. coli, a main causing agent of uncomplicated CUI, demonstrates high resistance to ampicilline and cotrimoxasol. High microbiological activity is shown byfluoroquinolones, nitrofurantoin, oral cephalosporines of the second-third generation. |
