Antibiotic resistance of Escherichia coli isolated from uncomplicated UTI in general practice patients over a 10-year period

Abstract

Recommendations of first choice antibiotic therapy need to be based on actual antibiotic susceptibility data. We determined the antibiotic susceptibility of E. coli in uncomplicated UTI among women and compared the results with 2004 and 2009. In 30 sentinel general practitioner practices of Nivel Primary Care database, urine samples were collected from women with symptoms of uncomplicated UTI. Patient characteristics, E. coli susceptibility, and ESBL production were analyzed. Six hundred eighty-nine urine samples were collected; E. coli was the most isolated uropathogen (83%). Antibiotic susceptibility was stable over time except for ciprofloxacin (96% in 2004, 97% in 2009, and 94% in 2014; P < 0.05). The susceptibility to co-amoxiclav was 88%, 87%, and 92% in 2004, 2009, and 2014, respectively. The prevalence of ESBL-producing E. coli increased from 0.1% in 2004 to 2.2% in 2014 (P < 0.05). Regional differences in antibiotic susceptibility for co-trimoxazole were found being the highest in the west (88%) and the lowest in the north (72%, P = 0.021). Ciprofloxacin susceptibility was related to antibiotic use in the past 3 months (97% no use versus 90% use, P = 0.002) and age > 70 years (P = 0.005). In 2014, prescription of fosfomycin increased compared to 2009 (14.3% versus 5.6%) at the expense of co-amoxiclav, co-trimoxazole, and fluoroquinolones (P < 0.05). The susceptibility percentages to most antimicrobial agents tested were stable over 10 years’ period although the prevalence of E. coli and ESBLs significantly increased. Performance of a survey with regular intervals is warranted.

Bacteriological profile and sensitivity pattern of urinary tract infection patients in north east part of Bangladesh

“…In contrary to these findings western countries practicing rational use of antimicrobials shows that susceptibility percentages to most antimicrobial agents tested were stable over 10 years' period although the prevalence of E. coli and ESBLs significantly increased. 27 Overall antimicrobial sensitivity and resistance of isolated uropathogens in this study showed relatively high resistance to amoxicillin (52%), cotrimoxazole (66.90%) cefixime (83.30%), cefuroxime (81.40%) and ceftriaxone (68.90%) which correlates with a previous study done by Haque gentamycin 64.90% were found to be sensitive to identified uropathogens. These findings are quite consistent to the findings of another study done in King Fahad Hospital Saudi Arabia.…”

Escherichia coli Resistance to Fluoroquinolones in Community-Acquired Uncomplicated Urinary Tract Infection in Women: a Systematic Review

“…However, it should be noted that data were provided by 12 centers in the United Kingdom for ECO·SENS II and only 2 centers in the ECO SENS 2014 update, which could impact these findings. In Germany, a primary care study reported a ciprofloxacin resistance rate of 8.7% in 2011 ( 29 ), with a higher incidence of 15.7% in a separate, later outpatient study ( 30 ), and a similar picture was reported for the Netherlands (from 3% in 2009% to 6% in 2014), with both studies using the same nationwide primary care data source ( 4 , 31 ). Resistance rates in Spain were somewhat higher than in other European countries, and data from a large study (2008 to 2009) showed a ciprofloxacin resistance rate of 22.9% compared with 30.8% in ECO·SENS (2014); albeit, the latter rate was from a more geographically restricted sample ( 24 , 28 ).…”

Oral fosfomycin for the treatment of lower urinary tract infections among kidney transplant recipients—Results of a Spanish multicenter cohort

“…A previous study including different patient populations demonstrated a cure rate of 55% for UTI produced by MDR bacteria . Various European surveillance studies have reported susceptibility rates for E. coli isolates exceeding 96%, which have remained stable over the previous 10 years . A recent German study found that 78% of carbapenem‐nonsusceptible Enterobacteriaceae isolates (including KPC, VIM, NDM, and OXA‐48 carbapenemases producers) remained susceptible to fosfomycin …”