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Canadian Journal of Infectious Diseases
Volume 12, Issue 5, Pages 289-292
Original Article

Susceptibility of Community Gram-Negative Urinary Tract Isolates to Mecillinam and Other Oral Agents

Tony Mazzulli,1 Martin Skulnick,1 Glen Small,1 Wayne Marshall,1 Darryl J Hoban,2 George G Zhanel,2 Susan Finn,3 and Donald E Low1

1Department of Microbiology, Mount Sinai and Princess Margaret Hospitals, University of Toronto, Toronto, Ontario, Canada
2Department of Clinical Microbiology, Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada
3Med-Chem Health Care Ltd, Toronto, Ontario, Canada

Received 30 October 2000; Accepted 24 January 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.