Emerging antibiotic resistance in urinary tract pathogens.

In vitro antimicrobial resistance is an evolving and growing problem in UTI. Much of the increase is occurring in acute uncomplicated cystitis, an infection that has traditionally been simple to treat. The current trend of rising TMP-SMX and beta-lactam resistance rates is worrisome. Of more concern, however, are the emerging issues of fluoroquinolone resistance and MDR among community-acquired urinary isolates. Judicious use of antibiotics and development of novel nonantimicrobial-based methods of prevention of UTI are important strategies to help slow the progression of resistance. In the meantime, ongoing surveillance of resistance trends and enhanced understanding of the determinants of resistance are crucial for optimal management of UTIs.