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Antimicrobial resistance patterns of gram-negative bacteria isolated from urine cultures at a general hospital.

To evaluate the antimicrobial resistance patterns of the Gram-negative organisms isolated from urine culture, we retrospectively analyzed the urine cultures and antibiotic sensitivity tests of inpatients and outpatients in our hospital between 1999 and 2002. A total of 11,659 urine specimens were analyzed of which 2054(17.6%) showed significant growth; 1764 (85.9%) were Gram-negative organisms. The most frequently isolated Gram-negative organisms were Escherichia coli 1026 (58%) and Klebsiella pneumoniae 293 (16.6%). The resistance rates for strains of E. coli isolated from the hospitalized patients were 61% to amoxicillin, 35% to amoxicillin-clavulanate, 47% to trimethoprim, 38% to ciprofloxacin, 31% to cephalexin and 13% to gentamicin. These rates were higher than those from the outpatients (52%, 36%, 40%, 32%, 29% and 5%), respectively. Out of the 42(2%) multidrug resistant E. coli and K. pneumoniae, 23(1%) were found to be positive for extended spectrum beta lactamase (ESBL) including 14 isolates of E. coli and 9 of K. pneumoniae. We conclude that our findings demonstrate a significant increase of resistance to various groups of antimicrobial drugs in the urine culture isolated from both inpatients and outpatients.