{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:48:10Z","timestamp":1773967690950,"version":"3.50.1"},"reference-count":0,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2000,1,1]],"date-time":"2000-01-01T00:00:00Z","timestamp":946684800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["MOP-86494"],"award-info":[{"award-number":["MOP-86494"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Canadian Journal of Infectious Diseases and Medical Microbiology"],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:p>BACKGROUND: Trimethoprim\u2010sulfamethoxazole (TMP\u2010SMX) has been a traditional first\u2010line antibiotic treatment for acute cystitis; however, guidelines do not recommend TMP\u2010SMX in regions where <jats:italic>Escherichia coli<\/jats:italic> resistance exceeds 20%. While resistance is increasing, there are no recent Canadian estimates from a primary care setting to guide prescribing decisions.<\/jats:p><jats:p>METHODS: A total of 330 family physicians assessed 752 women with suspected acute cystitis between 2009 and 2011. Physicians documented clinical features and collected urine for cultures for 430 (57.2%) women. The proportion of resistant isolates of <jats:italic>E coli<\/jats:italic> and exact binomial 95% CIs were estimated nationally, and compared regionally and demographically. These estimates were compared with those from a 2002 national study.<\/jats:p><jats:p>RESULTS: The proportion of TMP\u2010SMX\u2010resistant <jats:italic>E coli<\/jats:italic> was 16.0% nationally (95% CI 11.3% to 21.8%). This was not statistically higher than 2002 (10.9% [P=0.14]). TMP\u2010SMX resistance was increased in women \u226450 years of age (21.4%) compared with older women (10.7% [P=0.037]). In women with no antibiotic exposure in the previous three months, TMP\u2010SMX\u2010resistant <jats:italic>E coli<\/jats:italic> remained more prevalent in younger women (21.8%) compared with older women (4.4% [P=0.003]). The proportion of ciprofloxacin\u2010resistant <jats:italic>E coli<\/jats:italic> was 5.5% nationally (95% CI 2.7% to 9.9%), and was increased compared with 2002 (1.1% [P=0.036]). Ciprofloxacin resistance was highest in British Columbia (17.7%) compared with other regions (2.7% [P=0.003]), and was increased compared with 2002 levels in this province (0.0% [P=0.025]). Nitrofurantoin\u2010resistant <jats:italic>E coli<\/jats:italic> levels were low (0.5% [95% CI 0.01% to 2.7%).<\/jats:p><jats:p>DISCUSSION: The proportion of TMP\u2010SMX\u2010resistant <jats:italic>E coli<\/jats:italic> causing acute cystitis in women in Canada remains below 20% nationally, but may exceed this level in premenopausal women. Ciprofloxacin resistance has increased, notably in British Columbia. Nitrofurantoin resistance levels are low across the country. These observations indicate that TMP\u2010SMX and nitrofurantoin remain appropriate empirical antibiotic agents for treating cystitis in primary care settings in Canada.<\/jats:p>","DOI":"10.1155\/2013\/547848","type":"journal-article","created":{"date-parts":[[2016,3,15]],"date-time":"2016-03-15T07:59:33Z","timestamp":1458028773000},"page":"143-149","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Antibiotic\u2010Resistant <i>Escherichia coli<\/i> in Women with Acute Cystitis in Canada"],"prefix":"10.1155","volume":"24","author":[{"given":"Warren J","family":"McIsaac","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahim","family":"Moineddin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Meaney","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tony","family":"Mazzulli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,1]]},"container-title":["Canadian Journal of Infectious Diseases and Medical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/cjidmm\/2013\/547848.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/2013\/547848","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T23:21:35Z","timestamp":1723072895000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/2013\/547848"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,1]]},"references-count":0,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2013,1]]}},"alternative-id":["10.1155\/2013\/547848"],"URL":"https:\/\/doi.org\/10.1155\/2013\/547848","archive":["Portico"],"relation":{},"ISSN":["1712-9532","1918-1493"],"issn-type":[{"value":"1712-9532","type":"print"},{"value":"1918-1493","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,1]]},"assertion":[{"value":"2013-01-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}