Community-Onset Urinary Tract Infections Caused by Fluoroquinolone-Resistant Escherichia coli

Previously, fluoroquinolones (FQs) were the drugs of choice for community-onset urinary tract infections (UTIs). Escherichia coli, the most common uropathogen, was highly susceptible to these agents. Now, however, the situation is changing, with the emergence of FQ-resistant E. coli strains in the community.

To identify patient-related and environmental risk factors for FQ resistance, researchers in the Netherlands conducted a multicenter study involving adults who presented with community-onset febrile UTIs from 2004 through 2009 (n=787). In 420 (53%) of these patients, E. coli was the causal pathogen. Fifty-one (12%) of the 420 E. coli isolates showed FQ resistance. On multivariate analysis, risk factors for FQ-resistant E. coli were FQ us…