A study of uropathogenic Escherichia coli from men in regional NSW (Australia) with special emphasis on antibiotic resistance

Abstract

Background: Escherichia coli is an important uropathogen, responsible for most urinary tract infections (UTIs). Most studies on E. coli UTI pathogenesis have been in females, with limited studies on urinary isolates from men. Understanding UTI epidemiology in men is important in UTI management in this gender, including formulation of empirical treatment guidelines. Methods: We studied the distribution of 310 uropathogenic E. coli isolates from men by uro-clinical syndrome, hospitalisation status, age group, and antibiotic susceptibility. Results: Most of the E. coli isolates were from the outpatient setting (189, 61%), with the various age groups generally evenly distributed. In the inpatient setting, the 0-10 years age group was not represented, and the remaining 3 age groups were evenly represented (22-27%). Most of the isolates (74%) were from cystitis cases. For pyelonephritis isolates, the majority (65%) were confined to the 21-40 years age group, and the least in the 11-20 years age group (12%). Antibiotic (and multidrug) resistance was higher in pyelonephritis vs. cystitis isolates (73% vs. 58% ; P = 0.023, for multidrug resistance). Overall, antibiotic resistance differed significantly by age; highest in the 21-40 years age range (69%), and lowest in the 0-10 years group (39%). Likewise, ESBL production was highest in the 21-40 years age range (10%), and lowest in the 0-10 years age (0%). Conclusion: We documented a significant difference in the distribution of antibiotic resistance by age group amongst UPEC isolates from men in regional NSW, Australia, in the 0-60 years age group.