Ronald P Olson1, Karen Haith. 1. Duke University Health Service, Duke University, Durham, North Carolina 27710, USA. ron.olson@duke.edu
Abstract
OBJECTIVE: To determine resistance to antibiotics of Escherichia coli in uncomplicated urinary tract infections (uUTIs) in female college students. PARTICIPANTS: Symptomatic patients presenting to a student health service from September 2008 to December 2009. METHODS: Clean catch midstream urine samples were tested for urinalysis (UA) and culture and sensitivity. RESULTS: Of 168 students enrolled in the study, 138 had positive UA, and 94 of these grew >100,000 colonies/mL of E. coli. Ampicillin resistance was 31.9%, trimethoprim-sulfamethoxazole (TMP-SMX) resistance 16.0%, ciprofloxacin resistance 4.3%, amoxicillin/clavulanate resistance 3.2%, and nitrofurantoin resistance 1.1%. The sensitivity of UA was 95.4% and the positive predictive value was 87.0% (p ≤ .001). Specificity was 77.5% and negative predictive value 92.9%. CONCLUSIONS: In healthy college women with uUTI symptoms, TMP-SMX should not be universally used for empirical therapy, whereas use of ciprofloxacin, amoxicillin/clavulanate, and nitrofurantoin are appropriate.
OBJECTIVE: To determine resistance to antibiotics of Escherichia coli in uncomplicated urinary tract infections (uUTIs) in female college students. PARTICIPANTS: Symptomatic patients presenting to a student health service from September 2008 to December 2009. METHODS: Clean catch midstream urine samples were tested for urinalysis (UA) and culture and sensitivity. RESULTS: Of 168 students enrolled in the study, 138 had positive UA, and 94 of these grew >100,000 colonies/mL of E. coli. Ampicillin resistance was 31.9%, trimethoprim-sulfamethoxazole (TMP-SMX) resistance 16.0%, ciprofloxacin resistance 4.3%, amoxicillin/clavulanate resistance 3.2%, and nitrofurantoin resistance 1.1%. The sensitivity of UA was 95.4% and the positive predictive value was 87.0% (p ≤ .001). Specificity was 77.5% and negative predictive value 92.9%. CONCLUSIONS: In healthy college women with uUTI symptoms, TMP-SMX should not be universally used for empirical therapy, whereas use of ciprofloxacin, amoxicillin/clavulanate, and nitrofurantoin are appropriate.