Antimicrobial resistance of urinary tract isolates in acute uncomplicated cystitis among college-aged women: choosing a first-line therapy

OBJECTIVE AND PARTICIPANTS: The authors of this retrospective case study focused on antimicrobial susceptibility of urinary tract isolates in cases of acute uncomplicated cystitis in college-aged women, aged 18 to 24 years, diagnosed at a major south-central university student health center. METHODS: The authors obtained pertinent data from patient medical and laboratory records, including, diagnoses, urine culture, and susceptibility results. RESULTS: Of 179 isolates, 161 (90%) were Escherichia coli (E. Coli) isolates, of which 23% were resistant to trimethoprimsulfamethoxazole, <1% were resistant to Ciprofloxacin, and <1% were resistant to nitrofurantoin. Sixty-eight (42%) E. Coli isolates were multidrug resistant. There were 18 isolates cultured in the study group that were significant organisms other than E. coli. For all organisms in the study group, there was a combined resistance rate of 22% to trimethoprim-sulfamethoxazole, <1.0% for Ciprofloxacin, and 7% for nitrofurantoin. CONCLUSIONS: The findings suggest that both Ciprofloxacin and Nitrofurantoin are acceptable choices for empiric therapy of acute uncomplicated urinary tract infection in this study population, keeping in mind the potential for rising resistance rates to Ciprofloxacin in the community setting.     

‘A drop in the bucket‘: Collective efficacy perceptions and environmental behaviour

Environmental degradation is a complex problem, many aspects of which may not be solved unless collective effort is undertaken. Collective Efficacy theory provides a useful framework to investigate how people view their ability and the effectiveness of their actions to solve environmental problems, which has been largely overlooked until now. Six focus groups were conducted to explore efficacy beliefs expressed by environmental Activists and Non‐Activists in Perth, Western Australia, relating to waste management. All participants (n=38) expressed pessimistic views about the abilities of others to perform pro‐environmental behaviours. However, Activists were positive that a collective effort would be effective (‘many drops will fill up the bucket’) while Non‐Activists felt strongly that the problem would still exist even if everyone performed waste‐minimising behaviours (‘it's just a drop in the bucket’). Behaviour change interventions might be more effective if they focus on convincing people that collective effort will be effective in solving environmental problems.