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Acute cystitis is the most frequent symptomatic infection in females and the urological condition which results in more visits to the clinic. The empirical treatment commonly instituted requires a continuous update of local microbial susceptibility to keep resistance emergence under control and reduce costs. Our goal was to study the current susceptibility of all urological pathogens isolated in acute cystitis in female patients.Prospective study on 218 cases of acute cystitis in females reported between March 2000 and November 2000 in Health Centres within our Health Care Area. Patients were distributed by age range also including other parameters such as history of previous cystitis and predisposing factors, clinical sings and symptoms, as well as isolated micro-organisms and their "in vitro" susceptibility and MIC (Minimum Inhibitory Concentration) against the anti-microbial agents most commonly used in the clinical practice.The larger age groups were 25-35 and 65-75 years. 162 cases were intermittent and 56 were repeat cystitis. Haematuria was present in 14% cases. The microbial spectrum was similar in all groups; overall E. coli was isolated in 82.1% cases, K. pneumonia in 6%, S. agalactiae 3.7%, E. faecalis 2.3%, P. mirabilis 1.8% etc. Resistance rates for E. coli were: 0.6% for cefixime, 1.1% for amoxycillin-clavulanate, 1.7% tobramycin, 2.8% fosfomycin, 3.3% nitrofurantoin, 18.4% ciprofloxacin, 19.6% norfloxacin, 22.3% pipemidic acid, 35.8% co-trimoxazol and 54.7% ampicillin. Repeat cystitis was more frequent in patients over 65 years with higher resistance rates mainly in the quinolones group (28.6% ciprofloxacin and 30.4% norfloxacin for E. coli). Mean MIC for ciprofloxacin with regard to E. coli was: 1.503 mcg/mL (range: 0.06-8) and 3.96 mcg/mL (range: 1-16) for amoxycillin-clavulanate.High E. coli resistance rates to quinolones are still persistent. Excellent susceptibility to amoxycillin-clavulanate, cefixime and aminoglycosides, which allows for their use in short-term treatment regimes. High resistance rates to urinary antiseptic agents such as co-trimoxazol and ampicillin, and low rates for agents such as fosfomycin and nitrofurantoin. |
