Asymptomatic Bacteriuria Treatment is Associated with A Higher Prevalence of Antibiotic Resistant Strains in Women with Urinary Tract Infections.
Clin Infect Dis. 2015 Aug 12;
Authors: Cai T, Nesi G, Mazzoli S, Meacci F, Lanzafame P, Caciagli P, Mereu L, Tateo S, Malossini G, Selli C, Bartoletti R
Abstract
BACKGROUND: Women suffering from recurrent urinary tract infections (rUTIs) are routinely treated for asymptomatic bacteriuria (AB), but the consequences of this procedure on antibiotic resistance are not fully known. The aim of this study is to evaluate the impact of AB treatment on antibiotic resistance among women with rUTIs.
METHODS: The study population consisted of two groups of women who had previously been enrolled in a randomized clinical trial: group A - not treated and group B - treated. All women were scheduled for follow-up visits every 6 months, or more frequently if symptoms arose. Microbiological evaluation was performed on symptomatic women only. All women were followed up for a mean period of 38.8 months to analyze data from urine cultures and antibiograms.
RESULTS: The previous study population consisted of 673 women, however, 123 did not attend the entire follow-up period. For final analysis, of the remaining 550 patients, 257 were assigned to group A and 293 to group B. At the end of follow-up a statistically significant difference (p<0.001) was found in recurrence values: 97 (37.7%) in group A and 204 (69.6%) in group B. Isolated Escherichia coli from the treated group B showed a higher resistance to amoxicillin/clavulanic acid (p=0.03), trimethoprim-sulfamethoxazole (p=0.01) and ciprofloxacin (p=0.03) than group A.
CONCLUSIONS: This study shows that AB treatment is associated with a higher occurrence of antibiotic resistant bacteria, highlighting that AB treatment in women with rUTIs is potentially dangerous.
PMID: 26270684 [PubMed - as supplied by publisher]