Open Access Highly Accessed Research article

Resistance profiles of urinary tract infections in general practice - an observational study

Guido Schmiemann1*, Ildikó Gágyor2, Eva Hummers-Pradier2 and Jutta Bleidorn3

Author Affiliations

1 Department for Health Services Research, Institute for Public Health and Nursing Science, Universität Bremen, Bremen, Germany

2 Department of General Practice and Family Medicine, University of Goettingen, Göttingen, Germany

3 Institute of General Practice and Family Medicine, Hanover Medical School, Hannover, Germany

For all author emails, please log on.

BMC Urology 2012, 12:33  doi:10.1186/1471-2490-12-33

Published: 21 November 2012

Abstract

Background

Guideline recommendations on therapy in urinary tract infections are based on antibiotic resistance rates. Due to a lack of surveillance data, little is known about resistance rates in uncomplicated urinary tract infection (UTI) in general practice in Germany. In a prospective observational study, urine cultures of all women presenting with urinary tract infections in general practice were analysed. Resistance rates against antibiotics recommended in German guidelines on UTI are presented.

Methods

In a prospective, multi-center observational study general practitioner included all female patients ≥ 18 years with clinically suspected urinary tract infection. Only patients receiving an antibiotic therapy within the last two weeks were excluded.

Results

40 practices recruited 191 female patients (mean age 52 years; range 18–96) with urinary tract infections. Main causative agent was Escherichia coli (79%) followed by Enterococcus faecalis (14%) and Klebsiella pneumoniae (7.3%).

Susceptibiliy of E.coli as the main causative agent was highest against fosfomycin and nitrofurantoin, with low resistance rates of 4,5%; 2,2%. In 17,5%, E.coli was resistant to trimethoprim and in 8,5% to ciprofloxacin.

Conclusions

Resistance rates of uropathogens from unselected patients in general practice differ from routinely collected laboratory data. These results can have an impact on antibiotic prescribing and treatment recommendations.

Keywords:
Urinary tract infection; Primary care; Drug resistance; Anti-bacterial agents