High-level trimethoprim resistance in urinary bacteria.

The results of a three year evaluation of the incidence and type of trimethoprim resistance in pathogens responsible for significant bacteriuria in a general hospital in Edinburgh UK, are presented and compared to results of a previous study. In the present study, trimethoprim resistance was 50% more frequent in bacteria isolated from men and nearly twice as frequent in bacteria from elderly patients. However, the proportion of trimethoprim resistant strains fell annually when resistance was measured at trimethoprim concentrations of both 10 mg/l and 1000 mg/l. The proportion of strains able to transfer trimethoprim resistance also fell by half, and there was some movement of trimethoprim resistance transposons into the bacterial chromosome. These results suggest that migration of high-level trimethoprim resistance genes into the permanent location of the bacterial chromosome is occurring.