CJIDMM Canadian Journal of Infectious Diseases 1180-2332 Pulsus Group Inc 601743 10.1155/2001/601743 Original Article Susceptibility of Community Gram-Negative Urinary Tract Isolates to Mecillinam and Other Oral Agents Mazzulli Tony tmazzulli@mtsinai.on.ca 1 Skulnick Martin 1 Small Glen 1 Marshall Wayne 1 Hoban Darryl J 2 Zhanel George G 2 Finn Susan 3 Low Donald E 1 1 Department of Microbiology, Mount Sinai and Princess Margaret Hospitals University of Toronto Toronto, Ontario Canada utoronto.ca 2 Department of Clinical Microbiology, Health Sciences Centre University of Manitoba Winnipeg, Manitoba Canada umanitoba.ca 3 Med-Chem Health Care Ltd Toronto, Ontario Canada 2001 1 10 2001 12 5 289 292 30 10 2000 24 01 2001 2001 Copyright © 2001 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

OBJECTIVE: To determine the susceptibility of community outpatient Gram-negative urinary tract isolates to mecillinam and other commonly used oral agents.

DESIGN AND SETTING: The study was a laboratory-based study of consecutive Gram-negative urinary tract isolates. Only those isolates considered to be significant pathogens were included in the study. Susceptibility testing was performed using agar dilution methodology following guidelines published by the National Committee for Clinical Laboratory Standards.

POPULATION STUDIED: Outpatients presenting to a family physician or clinic with signs or symptoms suggestive of a urinary tract infection were included in the study.

MAIN RESULTS: Of 2000 consecutive community isolates (91.8% Escherichia coli, 3.9% Klebsiella species, 2.0% Proteus species, 2.3% others), in vitro susceptibilities were: mecillinam 98.8%, ampicillin 77.0%, ciprofloxacin 100%, trimethoprim/sulfamethoxazole 91.6% and nitrofurantoin 95.4%. Susceptibility to mecillinam was significantly better than all other agents except ciprofloxacin (P<0.001, McNemar's test). Organisms with reduced susceptibility to mecillinam included Citrobacter species, Pseudomonas aeruginosa and Providencia species.

CONCLUSIONS: Community Gram-negative urinary tract isolates remain highly sensitive to mecillinam and ciprofloxacin, but a significant number have developed resistance to trimethoprim/sulfamethoxazole. Further studies are required to determine the clinical significance of these results.

 Gram-negative organisms Outpatients Urinary tract infections Leo Pharma Inc