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Emergence of trimethoprim resistance among urinary tract Escherichia coli strains, isolated mostly from long-term patients in the Turku City Hospital, Turku, Finland, was studied from 1971 through 1984. Emergence of resistance to trimethoprim was associated with changes in the consumption of both trimethoprim-sulfamethoxazole and trimethoprim, with occurrence of high-level trimethoprim resistance and sequences homologous to trimethoprim resistance transposon Tn7. Since 1971, resistance of E. coli to trimethoprim-sulfamethoxazole increased from 8 to between 32 and 35% in 1983 and 1984; resistance to sulfamethoxazole varied from 39 to between 40 and 44%. The frequency of DNA sequence homology with our Tn7 probe among trimethoprim-resistant E. coli strains was 42% from 1980 to 1981 and 64% in 1983 (P less than 0.005). Fourteen years after the introduction of trimethoprim therapy in this hospital, resistance has reached the level of resistance to sulfonamide.

Emergence of trimethoprim resistance in relation to drug consumption in a Finnish hospital from 1971 through 1984