Urinary Tract Infections and a Multidrug-ResistantEscherichia coliClonal Group

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Abstract
The report by Manges et al. (Oct. 4 issue)1 regarding the widespread distribution of multidrug-resistant Escherichia coli is both important and timely. We have found even higher rates of resistance to trimethoprim–sulfamethoxazole (TMP-SMX) among E. coli and other organisms at Elmhurst Hospital in Queens, New York. This hospital serves an incredibly diverse immigrant population that includes large numbers of people from Asia and Latin America. As part of a quality-improvement project, we reviewed more than 900 positive urine cultures that had been obtained since October 1998; approximately 40 percent were resistant to TMP-SMX. The majority of our urine cultures grew E. coli with patterns of resistance that were similar to those reported by Manges et al.