Sofia Ny1, Petra Edquist2, Uga Dumpis3, Kirsi Gröndahl-Yli-Hannuksela4, Julia Hermes5, Anna-Maria Kling2, Anja Klingeberg5, Roman Kozlov6, Owe Källman7, Danuta O Lis8, Monika Pomorska-Wesołowska8, Māra Saule3, Karin Tegmark Wisell2, Jaana Vuopio4, Ivan Palagin6. 1. Public Health Agency of Sweden, Nobels väg 18, 17182 Solna, Sweden; Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Alfred Nobels allé 10, 141 52 Huddinge, Sweden. Electronic address: sofia.ny@folkhalsomyndigheten.se. 2. Public Health Agency of Sweden, Nobels väg 18, 17182 Solna, Sweden. 3. Pauls Stradins Clinical University Hospital, Pilsoņu iela 13, Zemgales priekšpilsēta, Rīga, LV-1002, Latvia. 4. Institute of Biomedicine, University of Turku, Kiinamyllynkatu 10, 20520 Turku, Finland. 5. Robert Koch-Institut, Seestraße 10, 13353 Berlin, Germany. 6. Institute of Antimicrobial Chemotherapy of Smolensk State Medical University, P.O. Box N5, Smolensk 214019, Russian Federation. 7. Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Alfred Nobels allé 10, 141 52 Huddinge, Sweden; Department of Communicable Disease Control and Prevention, Stockholm County Council, Magnus Ladulåsgatan 63A, 118 91 Stockholm, Sweden. 8. Institute of Occupational Medicine and Environmental Health, Kościelna 13, 40-001 Sosnowiec, Poland.
Abstract
OBJECTIVES: In the Northern Dimension Antibiotic Resistance Study (NoDARS), Finland, Germany, Latvia, Poland, Russia and Sweden collected urine samples from outpatient women (aged 18-65years) with symptoms of uncomplicated urinary tract infection (UTI) to investigate the levels of antimicrobial resistance (AMR) among Escherichia coli isolates. METHODS: A total of 775 E. coli isolates from 1280 clinical urine samples were collected from October 2015 to January 2017. Antimicrobial susceptibility testing was performed and the results were interpreted according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria. RESULTS: Overall AMR rates to the commonly used antibiotics nitrofurantoin, fosfomycin and mecillinam (except for Germany that was missing a result for mecillinam) were 1.2%, 1.3% and 4.1%, respectively. The highest overall resistance rates were determined for ampicillin (39.6%), trimethoprim (23.8%), trimethoprim/sulfamethoxazole (22.4%), amoxicillin/clavulanic acid (16.7%) and ciprofloxacin (15.1%), varying significantly between countries. The rate of extended-spectrum β-lactamase (ESBL) production was 8.7%. None of the isolates showed resistance to meropenem. CONCLUSIONS: In most cases, low AMR rates were detected against the first-line antibiotics recommended in national UTI treatment guidelines, giving support to their future use. These results also support the European Association of Urology guidelines stating that nitrofurantoin, fosfomycin and mecillinam are viable treatment options for uncomplicated UTI.
OBJECTIVES: In the Northern Dimension Antibiotic Resistance Study (NoDARS), Finland, Germany, Latvia, Poland, Russia and Sweden collected urine samples from outpatientwomen (aged 18-65years) with symptoms of uncomplicated urinary tract infection (UTI) to investigate the levels of antimicrobial resistance (AMR) among Escherichia coli isolates. METHODS: A total of 775 E. coli isolates from 1280 clinical urine samples were collected from October 2015 to January 2017. Antimicrobial susceptibility testing was performed and the results were interpreted according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria. RESULTS: Overall AMR rates to the commonly used antibiotics nitrofurantoin, fosfomycin and mecillinam (except for Germany that was missing a result for mecillinam) were 1.2%, 1.3% and 4.1%, respectively. The highest overall resistance rates were determined for ampicillin (39.6%), trimethoprim (23.8%), trimethoprim/sulfamethoxazole (22.4%), amoxicillin/clavulanic acid (16.7%) and ciprofloxacin (15.1%), varying significantly between countries. The rate of extended-spectrum β-lactamase (ESBL) production was 8.7%. None of the isolates showed resistance to meropenem. CONCLUSIONS: In most cases, low AMR rates were detected against the first-line antibiotics recommended in national UTI treatment guidelines, giving support to their future use. These results also support the European Association of Urology guidelines stating that nitrofurantoin, fosfomycin and mecillinam are viable treatment options for uncomplicated UTI.
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