Abstract
BackgroundUncomplicated urinary tract infections (UTI) are a frequent reason for consultation of women in primary health care. To avoid therapy failure and development of resistances, the choice of an antibiotic should be based on the knowledge of recent local resistance data but these data are scarce for the Austrian primary health care sector. Within the context of the ECO·SENS II study it was the aim to obtain appropriate and relevant local resistance data and describe the changes in the resistance pattern in comparison to the ECO·SENS study.Methods23 GPs from different parts of Austria participated in the study between July 2007 and November 2008. According to the defined inclusion- and exclusion criteria female patients with symptoms of an uncomplicated UTI were included and a midstream urine sample was collected. In case of significant bacteriuria susceptibility testing of E. coli against 14 antibiotics was performed. Descriptive statistical methods were used.ResultsIn 313 patients included in the study, a total of 147 E. coli isolates (47%) were detected and tested. The resistance rates were in %: Mecillinam (0.0), nitrofurantoin (0.7), fosfomycin trometamol (0.7), gentamycin (1.4), cefotaxime (2.7), ceftazidime (2.7), Cephadroxil (4.1) and ciprofloxacin (4.1). Higher resistance rates were found in amoxicillin/clavulanic acid (8.9), nalidixic acid (9.6), trimethoprim/sulphamethoxazole (14.4), trimethoprim (15.8), sulphamethoxazole (21.2) and ampicillin (28.8). Additionally, the comparison of these results with the results of the ECO·SENS study demonstrated an increase in resistance rates of ampicillin, amoxicillin/clavulanic acid, nalidixic acid and ciprofloxacin.ConclusionsThe resistance data for E. coli in uncomplicated UTIs in women gained by this study are the most recent data for this disease in Austria at the moment. The increased resistance rates of amoxicillin/clavulanic acid, ciprofloxacin and nalidixic acid should be respected when choosing an appropriate antibiotic for uncomplicated UTIs. The use of ampicillin, sulphamethoxazole, trimethoprim and trimethoprim/sulphametoxazole in uncomplicated UTIs in women should be questioned at all. The findings of this study should result in a regular surveillance system of resistances emerging in the ambulatory sector designed after the model of the EARS-Net.
Highlights
Uncomplicated urinary tract infections (UTI) are a frequent reason for consultation of women in primary health care
Patients characteristics Within the study period of 71.4 weeks a total of 1,776 subjects were enrolled in the ECO·SENS II study in all five countries of which 1,697 cases could be analyzed
The study showed that 47% of women complaining of symptoms of an uncomplicated UTI had significant bacteriuria caused by E. coli which is 73.4% of all grown bacteria; a percentage very similar to the results found in the ECO·SENS study nine years before and the ARESC study from 2006 [16,17]
Summary
Uncomplicated urinary tract infections (UTI) are a frequent reason for consultation of women in primary health care. To avoid therapy failure and development of resistances, the choice of an antibiotic should be based on the knowledge of recent local resistance data but these data are scarce for the Austrian primary health care sector. Urinary tract infections (UTI) are a frequent reason for consultation of women in primary health care [1,2,3,4]. When antibiotics for treating an acute UTI are prescribed in primary health care the nature of the causative bacterium can only be presumed because current resistance data from the primary health care sector are scarce [10,11,12]. It is necessary to gain susceptibility data especially from the primary health care sector and from hospitals or specialized centre’s because these resistances differ from that seen in the ambulatory sector [18]
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