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Urinary tract infection caused by fluoroquinolone- and cephem-resistant Enterobacteriaceae.

Muratani T, Matsumoto T

Department of Urology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.

In 2001, fluoroquinolone-resistant Escherichia coli isolates emerged in Japan in patients with uncomplicated urinary tract infection (UTI), and accounted for ca. 8% of isolates. This is a worldwide occurrence as reported by the ECO.SENS study. The number of fluoroquinolone- and cephem-resistant Enterobacteriaceae isolates from patients with complicated UTI is increasing. Most cephem-resistant isolates of E. coli, Klebsiella pneumoniae and Proteus mirabilis produce extended-spectrum beta-lactamases (ESBLs). The rates of ESBL-producing Enterobacteriaceae differ between countries but there are ESBL producers in urinary Enterobacteriaceae isolates in most countries. More seriously, most nosocomial ESBL producers are also resistant to non-beta-lactams, such as the fluoroquinolones, fosfomycin and co-trimoxazole. This causes serious problems in the chemotherapy of cystitis.

Published 8 August 2006 in Int J Antimicrob Agents, 28: 10-3.
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