[Community acquired urinary tract infections - association with risk factors : Changes in causative organisms and resistance over time]

Published studies on community-acquired urinary tract infections (UTI) often do not link microbiological findings with clinical risk factors and patient data.

We retrospectively correlated clinical findings of all patients with UTI of a urological outpatient clinic with the respective microbiological analysis of their urine samples over 2 periods of time: (A: 2005-2006 and B: 2011-2012). Patients were stratified to the following risk groups: uncomplicated cystitis, diabetes mellitus type 2, nursing home resident, prostatitis/epidydimitis, permanent catheter.

The incidence of Escherichia coli (p < 0.001) and proteus (p < 0.001) significantly decreased from period A to B, while enterococci (p = 0.003) and staphylococci (p < 0.001) significantly increased. Antibiotic sensitivity to fosfomycin (p < 0.001), doxycycline (p < 0.001), nitrofurantoin (p < 0.001), and nitroxoline increased (p < 0. 001) and sensitivity to amoxicillin (p < 0.001) and gentamicin decreased (p < 0.001). Patients with a permanent catheter had significantly poorer sensitivity rates (50% and less) for almost all antibiotics tested compared to the overall group. The risk of a UTI with 3MRGN or MRSA bacteria was significantly higher for catheter carriers and nursing home residents.

Empiric antibiotic first-line therapy with nitrofurantoin and fosfomycin for uncomplicated community acquired UTIs are well indicated in conformity with guidelines. The accumulation of multiresistant pathogens in patients with a permanent bladder catheter requires restrictive use of any permanent catheter drainage.

Der Urologe. Ausg. A. 2017 Apr 27 [Epub ahead of print]

B Ubrig, M Böhme, A Merklinghaus, F Wagenlehner

Klinik für Urologie, , Augusta-Kranken-Anstalt gGmbH, Bergstr. 26, 44791, Bochum, Deutschland. ., Gemeinschaftspraxis für Urologie, Bochum-Wattenscheid, Bochum, Deutschland., Klinik für Urologie, , Augusta-Kranken-Anstalt gGmbH, Bergstr. 26, 44791, Bochum, Deutschland., Lehrstuhl für Urologie, Kinderurologie und Andrologie, Justus Liebig Universität Gießen, Gießen, Deutschland.

E-Newsletters

Newsletter subscription

Free Daily and Weekly newsletters offered by content of interest

The fields of GU Oncology and Urology are rapidly advancing. Sign up today for articles, videos, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.

Subscribe