[Resistance of ambulatory urinary infection pathogens according to the data of multicenter microbiological studies UTIAP-I and UTIAP-II]. / Rezistentnost' vozbuditelei ambulatornykh infektsii mochevyvodiashchikh putei po dannym mnogotsentrovykh mikrobiologicheskikh issledovanii UTIAP-I i UTIAP-II.

AIM: To study causative agents and sensitivity of E-coli strains isolated from adult outpatients with uncomplicated urinary infection (UI) in different regions of Russia. MATERIAL AND METHODS: A multicenter prospective epidemiological study included adult patients with uncomplicated infections of the upper or lower urinary tracts. MPK of antibiotics was established by dilution in agar according to NCCLS recommendations, 2000-2002. RESULTS: Among UI causative agents, E. coli was most frequent (85.9%). K. Pneumoniae, Proteus spp., Staphylococcus spp., P. Aeruginosa, Enterococcus spp. occurred much less frequently (6, 1.8, 1.6, 1.2, and 1.0%, respectively). E. Coli UI was highly resistant to ampicilline (37.1%), cotrimoxasol (21%), maximal resistance being in St-Petersburg (51.9 and 31.5%, respectively). Such oral antibiotics as norfloxacin and ciprofloxacin, cefuroxim, amoxicillin/clavulanat, nitrofurantoin were maximally active against E. Coli (4.3, 2.4, 2.6 and 1.2%, respectively). CONCLUSION: High resistance of E. coli, which is the chief causative agent of uncomplicated UI, to ampicillin, cotrimoxasol was detected. Fluoroquinolones, amoxicillin/clavulanat, nitrofurantoin, cefuroxim have high microbiological activity. On the basis of the pharmacokinetic, safety and other evidence it is concluded that drugs of choice for therapy of uncomplicated UI in Russia are oral fluoroquinolones.

[Antibacterial drug resistance of gram-negative agents causing urinary infections in female outpatients in Russia: results of multicenter study]. / Rezistentnost' gramotritsatel'nykh vozbuditelei infektsii mochevyvodiashchikh putei k antibakterial'nym preparatam u ambulatornykh patsientok v Rossii. Rezul'taty mnogotsentrovogo issledovaniia.

AIM: To investigate the spectrum of gram-negative agents causing acute and recurrent cystitis in outpatients and sensitivity of uropathogenic E. coli to antibacterial drugs; to compare drug resistance of uropathogenic E. coli isolated in Russia and other countries. MATERIAL AND METHODS: The spectrum of gram-negative bacteria was identified in 299 cases of acute and recurrent cystitis in Moscow, Smolensk and Novosibirsk. 271 E. coli uropathogenic strains were examined according to CA-SFM and NCCLS criteria for sensitivity to ampicilline, gentamycin, trimetoprim, co-trimoxasol, nitrofurantoine, nalidixic acid, pipemidine acid, norfloxacine, ciprofloxacine, nitroxoline. RESULTS: E. coli, K. pneumoniae, K. oxytoca, P. mirabilis, P. vulgaris caused acute and recurrent cystitis in 90.6, 6.4, 1, 1.7, 0.3% of the examinees, respectively. For Moscow relative agents were: E. coli (80.8%), K. pneumoniae (13.1%), K. oxytoca (2.3%), P. mirabilis (3.1%), P. vulgaris (0.7%). In Smolensk E. coli, K. pneumoniae, P. mirabilis were isolated in 96.3, 2.5 and 1.2%, respectively. E. coli occurred in 100% of Novosibirsk cases. Mean Russian values of the resistance to ampicilline, gentamycin, trimetoprim, co-trimoxasol, nitrofurantoin, nalidixic acid, pipemidine acid, norfloxacine, ciprofloxacine, nitroxoline were the following: 33.3, 5.9, 20.3, 18.4, 2.9, 5.5, 4.4, 2.6, 2.6 and 94.1%, respectively. Resistance to 2 and more drugs was registered in 18.4% of E. coli strains. CONCLUSION: Cystitis in women was in most cases caused by E. coli. The highest resistance among uropathogenic strains E. coli was observed to nitroxoline, ampicilline, trimetoprim and co-trimoxasole; maximal antibacterial activity against uropathogenic E. coli was shown by fluoroquinolones (norfloxacin and ciprofloxacin).