Abstract
Antimicrobial resistance (AMR) is an increasing problem. The prevalence of antimicrobial resistance in general practice patients is expected to be relatively high in Rotterdam, the Dutch city with the largest proportion non-Western immigrants. The aim of this study was to assess the prevalence of antibiotic-resistant uropathogens (Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis) in general practices in Rotterdam, and to find a possible association between the prevalence of antibiotic-resistant E. coli and age, gender, and socioeconomic status (SES). A retrospective analysis was performed of urine samples from general practice patients in 2016. The prevalence of AMR in uropathogens was compared with national resistance data, as was the prevalence of highly and multidrug resistant and extended spectrum β-lactamase (ESBL) producing E. coli and K. pneumoniae. Univariate logistic regression was used to study associations between antibiotic-resistant E. coli and age, gender, and SES area score. No clinically relevant differences were observed in the prevalence of antibiotic-resistant uropathogens in Rotterdam compared with the national prevalence. For E. coli and K. pneumoniae, the prevalence was 3.6% for ESBL production (both pathogens together), while the prevalence ranged between 4.2%–5.0% for high resistance and between 1.2%–3.3% for multidrug resistance. Ciprofloxacin-resistant E. coli was significantly associated with higher age. Although Rotterdam has a high percentage of non-western immigrants and a low SES, AMR is low among general practice patients. This indicates that adherence to national guidelines in general practice enables maintenance of low AMR, even in high-risk populations.
Highlights
Antimicrobial resistance (AMR) is an increasing public health problem
The data are obtained from the Infectious Diseases Surveillance Information System-Antimicrobial Resistance (ISIS-AR), a national surveillance system among microbiological laboratories that send their data—which are routinely obtained from patient samples—for analysis to the National Institute of Public Health and the Environment (RIVM) [2]
We hypothesised that the prevalence of antibiotic resistance in Rotterdam is higher than the national prevalence of AMR, due to its higher proportion of non-Western immigrants and the lower socioeconomic status (SES) score
Summary
Antimicrobial resistance (AMR) is an increasing public health problem. The prevalence of antibiotic-resistant microorganisms in the Netherlands is low compared with other countries in Europe and worldwide, resistance is increasing [1]. National data on the prevalence of antibiotic-resistant microorganisms are published annually in NethMap [2]. The data are obtained from the Infectious Diseases Surveillance Information System-Antimicrobial Resistance (ISIS-AR), a national surveillance system among microbiological laboratories that send their data—which are routinely obtained from patient samples—for analysis to the National Institute of Public Health and the Environment (RIVM) [2]. Risk factors contributing to the carriage of or infection with an antibiotic-resistant microorganism in the community include travel to foreign countries, frequent use of antibiotics, being born outside the Netherlands, recent (foreign) hospitalization, higher age, and comorbidity [4,5,6,7,8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
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 callMore From: European Journal of Clinical Microbiology & Infectious Diseases
Disclaimer: 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.
