To collect routine susceptibility data for coliforms isolated from patients with community-acquired urinary tract infections (UTIs) in Zenica-Doboj Canton, Bosnia and Herzegovina and to relate them to bacterial identification and patient demographics with a view to guiding empirical therapy.Methods
During 1998–2001, 54 638 consecutive urine samples were analysed by standard procedures. Antimicrobial susceptibility testing for 15 antimicrobials was performed by the disc diffusion method.Results
A total of 10 765 Escherichia coli and other coliforms were isolated, of which 5043 (46.8%) were duplicates. Resistance rates were significantly higher in duplicate isolates for almost all antibiotics tested (P < 0.05), except for ampicillin, cefazolin, aztreonam and co-trimoxazole. Inclusion of coliforms other than E. coli (25.8%) significantly increased resistance rates for all tested antibiotics (P < 0.001) except imipenem. Overall coliform resistance rates were significantly higher in males than in females (P < 0.001).Conclusions
Due to high ampicillin and trimethoprim/sulfamethoxazole resistance rates for all subsets analysed it is highly recommended to perform urinalysis and antibiotic susceptibility testing in all patients, except in the age group 0–6 years of male patients and in the age group 20–64 years of female patients, in which empirical therapy with these antibiotics can be applied. Nitrofurantoin should also be considered as the first-line therapy, especially in children. It is important for physicians to know susceptibility data for UTIs in order to optimize the use of empirical therapy.