Do we really know the prevalence of multi-drug resistant Escherichia coli in the territorial and nosocomial population?

Introduction: The purpose of this work was to evaluate the prevalence of the Quinolones resistant Escherichia coli and/or ESBL producers in the population of our catchment area and hospital component. Materials and Methods: From January 2008 to December 2010, all data concerning urine cultures in patients with suspected urinary tract infection and/or asymptomatic bacteriuria referring at our center located in the south of Milan were prospectively evaluated. Results: In 2008, 2136 outpatient and 1232 hospital urine cultures were analyzed. The presence of quinolone-resistant strains was 21% at a local level and 53% in hospitals. ESBL-producing strains were isolated in 3.5% of cases at a local level and 20.5% in hospitals. In 2009, 2396 outpatient and 1320 hospital urine cultures were analyzed. The presence of quinolone-resistant strains was 21% at a local level and 46% in hospitals. ESBL-producing strains were isolated in 5.4% of cases at a local level and 20% in hospitals. In 2010, 2601 outpatient and 1717 hospital urine cultures were analyzed. The presence of quinolone-resistant strains was 34% at a local level and 26% in hospitals. ESBL-producing strains were isolated in 6.7% of cases at a local level and 20.6% in hospitals. The multidrug resistance was significantly (P < 0.01) higher in ESBL-positive strains. Conclusion: Due to rising antibiotic resistance among uropathogens, it is important to have knowledge of the organisms causing urinary tract infections and their antibiotic sensitivity patterns. In areas with high prevalence of E. Coli resistance, performing urine culture before every surgical procedure became mandatory, in order to prevent fatal sepsis