Active surveillance of antibiotic resistance patterns in urinary tract infections in primary care in Switzerland.

Plate, Andreas; Kronenberg, Andreas; Risch, Martin; Mueller, Yolanda; Di Gangi, Stefania; Rosemann, Thomas; Senn, Oliver (2019). Active surveillance of antibiotic resistance patterns in urinary tract infections in primary care in Switzerland. Infection, 47(6), pp. 1027-1035. Springer-Medizin-Verlag 10.1007/s15010-019-01361-y

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PURPOSE Urinary tract infections (UTI) are one of the most common reasons for prescribing antibiotics in primary care. In Switzerland, the Swiss Center for Antibiotic Resistances (ANRESIS) provides resistance data by passive surveillance, which overestimates the true resistance rates. The aim of this study was to provide actual data of the antimicrobial resistance patterns in patients with UTI in Swiss primary care. METHODS From June 2017 to August 2018, we conducted a cross-sectional study in 163 practices in Switzerland. We determined the resistance patterns of uropathogens in patients with a diagnosis of a lower UTI and analyzed risk factors for resistance. Patients with age < 18 years, pregnancy or a pyelonephritis were excluded. RESULTS 1352 patients (mean age 53.8, 94.9% female) were included in the study. 1210 cases (89.5%) were classified as uncomplicated UTI. Escherichia coli (E. coli) was the most frequent pathogen (74.6%). Susceptibility proportions of E. coli to ciprofloxacin (88.9%) and trimethoprim-sulfamethoxazol (TMP/SMX) (85.7%) were significantly higher than the proportions reported by ANRESIS. We found high susceptibility to the recommended first-line antibiotics nitrofurantoin (99.5%) and fosfomycin (99.4%). Increasing age, antimicrobial exposure and a recent travel history were independently associated with resistance. DISCUSSION In this study, we report actual data on the resistance patterns of uropathogens in primary care in Switzerland. Escherichia coli showed low resistance rates to the recommended first-line antibiotics. Resistance to TMP/SMX was significantly lower than reported by ANRESIS, making TMP/SMX a suitable and cheap alternative for the empirical treatment.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases

UniBE Contributor:

Kronenberg, Andreas Oskar

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

0300-8126

Publisher:

Springer-Medizin-Verlag

Language:

English

Submitter:

Siegfried Hektor Hapfelmeier-Balmer

Date Deposited:

31 Jan 2020 09:20

Last Modified:

31 Jan 2020 09:20

Publisher DOI:

10.1007/s15010-019-01361-y

PubMed ID:

31595436

Uncontrolled Keywords:

E. coli Primary care Resistance rates Susceptibility rates Switzerland Urinary tract infection

BORIS DOI:

10.7892/boris.138184

URI:

https://boris.unibe.ch/id/eprint/138184

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