Incidence of urinary tract infections and antibiotic resistance in the outpatient setting: a cross-sectional study

Infection. 2017 Feb;45(1):33-40. doi: 10.1007/s15010-016-0910-2. Epub 2016 May 27.

Abstract

Purpose: In 2012-2013, a cross-sectional survey was conducted in women visiting a general practitioner for urinary tract infection (UTI), to estimate the annual incidence of UTIs due to antibiotic-resistant Escherichia coli (E. coli).

Methods: A sampling design (stratification, stages and sampling weights) was taken into account in all analyses. Urine analyses were performed for each woman and centralised in one laboratory.

Results: Among 538 included women, urine culture confirmed UTI in 75.2 % of cases. E. coli represented 82.8 % of species. Among E. coli, resistance (I + R) was most common to amoxicillin [38 % (95 % confidence interval 31.1-44.5)] and to trimethoprim/sulfamethoxazole [18.1 % (12.0-24.1)]. Resistance to ciprofloxacin and cefotaxime was lower [1.9 % in both cases, (0.3-3.5)], as it was for nitrofurantoin [0.4 (0-1.0)] and fosfomycin (0). Extended-spectrum β-lactamase (ESBL) represented 1.6 % of E. coli (0.2-2.9). Annual incidence rate of confirmed UTI was estimated at 2400 per 100,000 women (1800-3000). Incidence rates of UTI due to fluoroquinolone-resistant and ESBL-producing E. coli were estimated at 102 per 100,000 women (75-129) and at 32 (24-41), respectively.

Conclusions: ESBL had been found in a community population, and even though the rate was low, it represents a warning and confirms that surveillance should continue.

Keywords: Antibiotic resistance; Escherichia coli; General population; General practitioner; Incidence; Urinary tract infection.

MeSH terms

  • Adult
  • Ambulatory Care
  • Anti-Bacterial Agents / pharmacology
  • Bacteria / drug effects*
  • Bacterial Infections / epidemiology*
  • Bacterial Infections / microbiology*
  • Cross-Sectional Studies
  • Drug Resistance, Bacterial*
  • Escherichia coli / drug effects
  • Escherichia coli Infections / epidemiology
  • Escherichia coli Infections / microbiology
  • Female
  • Humans
  • Incidence
  • Microbial Sensitivity Tests
  • Middle Aged
  • Prospective Studies
  • Urinary Tract Infections / epidemiology*
  • Urinary Tract Infections / microbiology*

Substances

  • Anti-Bacterial Agents