Antimicrobial resistance in urinary tract infections caused by Escherichia coli

Urinary tract infections (UTI) are one of the most common bacterial infections in hospital and community settings requiring antimicrobial treatment. Escherichia coli (E. coli), a bacterium frequently implicated in UTI, is becoming increasingly resistant to antimicrobials. Antimicrobial resistance (AMR) reduces the effectiveness of antimicrobial agents, leading to difficulty in treatment of patients, with the potential to prolong the duration of illness and increase mortality in patients. To date in Australia, there is a paucity of data comparing resistance patterns over time for hospital- and community-acquired E. coli UTI with no published data on incidence and risk of urinary E. coli resistance in Australia. Ciprofloxacin, a high priority critically important antimicrobial, is not recommended for empirical therapy of UTI yet resistance to this antimicrobial agent is increasing. There are no systematic reviews of studies investigating ciprofloxacin resistance in hospital- and community-acquired E. coli UTI. Therefore, the research program sought to address these knowledge gaps in three separate but interrelated studies. The research described in this thesis is the first of its kind in Australia.