Risk factors for antibiotic-resistant Escherichia coli isolated from community-acquired urinary tract infections in Dakar, Senegal.

OBJECTIVES To assess overall resistance rates and risk factors for resistance to ampicillin, co-amoxiclav, nalidixic acid, fluoroquinolones and trimethoprim/sulfamethoxazole in Escherichia coli strains isolated from outpatients with acute urinary tract infection in Dakar (Senegal). PATIENTS AND METHODS From June 2001 to June 2003, a prospective study was performed among Senegalese outpatients consulting at the Institut Pasteur of Dakar for urine analysis. Evaluated risk factors were: age, gender, prior hospitalization, antibiotic exposure, urinary tract infection and urinary catheter. RESULTS A total of 398 non-duplicate, consecutive, biologically significant E. coli were isolated. The levels of antibiotic resistance in Dakar appeared dramatic and worrisome with resistance rates ranging from 18.6% for fluoroquinolones to 73.6% for ampicillin. With the exception of the presence of urinary catheter, the risk factors identified were consistent with data previously reported in developed countries. CONCLUSIONS We hope our results will assist medical authorities in the development of appropriate control strategies.