Sensitivity to nine antibiotics of bacterial isolates from urinary tract infections in a urological ward: Therapeutic deductions

Between January and May 1982 the species distribution and the drug sensitivity of the 800 bacterial strains isolated from the urological ward have been studied. E. coli and P. mirabilis represent 26.8% of the strains whereas Enterobacter represents 11.9%, Serratia 9.4% and enterococci 15.4%. The distribution of the species was similar to that of the strains isolated between January 1980 and July 1981. Considered as a whole, 72.5%, 56.5%, 50.5% of the strains were sensitive to cefotaxime, to mezlocillin and to colistin respectively. Less than 50% of the strains were sensitive to six other drugs tested. The sensitivity rate was 73.5% for the combination mezlocillin plus gentamicin and 70% for the combination colistin plus cotrimoxazole. There was no advantage in combining cefotaxime with gentamicin. As compared with the resistance observed during the period January 1980-July 1981, the resistance to cefotaxime of the Enterobacter, Serratia and Citrobacter isolated in 1982 had increased from 3% to 7.5%. During the same period, the consumption of cefotaxime increased threefold. To limit the selection and spread of cefotaxime-resistant organisms it is proposed to reserve cefotaxime as the drug of first choice for the treatment of life-threatening infections and to use either mezlocillin plus gentamicin or colistin plus cotrimoxazole as the drug combination of first-choice for treatment of less severe infections.