Abstract
We determined the prevalence and spread of antibiotic resistance and the characteristics of ESBL producing and/or multi drug resistant (MDR) Escherichia coli isolates collected from urine samples from urology services in the Euregio Meuse-Rhine, the border region of the Netherlands (n = 176), Belgium (n = 126) and Germay (n = 119). Significant differences in resistance between the three regions were observed. Amoxicillin-clavulanic acid resistance ranged from 24% in the Netherlands to 39% in Belgium (p = 0.018), from 20% to 40% (p<0.004) for the fluoroquinolones and from 20% to 40% (p = 0.018) for the folate antagonists. Resistance to nitrofurantoin was less than 5%. The prevalence of ESBL producing isolates varied from 2% among the Dutch isolates to 8% among the German ones (p = 0.012) and were mainly CTX-M 15. The prevalence of MDR isolates among the Dutch, German and Belgian isolates was 11%, 17% and 27%, respectively (p< = 0.001 for the Belgian compared with the Dutch isolates). The majority of the MDR and ESBL producing isolates belonged to ST131. This study indicates that most antibiotics used as first choice oral empiric treatment for UTIs (amoxicillin-clavulanic acid, fluoroquinolones and folate antagonists) are not appropriate for this purpose and that MDR strains such as CTX-M producing ST131 have spread in the entire Euregion. Our data stress the importance of ward specific surveillance to optimize empiric treatment. Also, prudent use of antibiotics and further research to alternative agents are warranted.
Highlights
The increase of antimicrobial resistance is a major concern worldwide
Significant differences in prevalence of antibiotic resistance between the three regions in the Euregion were found for several antimicrobial agents tested including the fluoroquinolones, and folate antagonists (Table 1)
Amoxicillin-clavulanic acid resistance ranged from 24% in the Netherlands to 39% in Belgium (p = 0.018)
Summary
The increase of antimicrobial resistance is a major concern worldwide. Surveillance studies showed an increase in resistance for both Gram positive and Gram negative bacteria [1], including Escherichia coli, the most prevalent causative agent of urinary tract infections (UTIs) [1,2,3,4]. Since microorganisms do not recognize national borders, cross border spread is likely to occur This is the case in the Euregion Meuse-Rhine (EMR), the border region of the Netherlands, Belgium and Germany. Current data of prevalence of antibiotic resistance including the prevalence of ESBL producing E. coli strains will guide physicians in their choice of adequate empiric treatment. Since such ward specific resistance data for patients visiting the urology services are hardly available we conducted a surveillance to determine the prevalence of (multi drug) resistant E. coli isolates including ESBL producing strains collected from patients visiting a urology service in the Euregion Meuse-Rhine
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
