Antibiotic resistance of Escherichia coli from outpatient urinary tract infection in women in six European countries including Russia.

In the Northern Dimension Antibiotic Resistance Study Finland, Germany, Latvia, Poland, Russia and Sweden investigated the resistance levels of Escherichia coli (E. coli) isolated from urine of outpatient women (18-65 years) that had symptoms of uncomplicated UTI by collecting samples in each respective nation.

In total 775 E. coli isolates from 1278 clinical urinary samples were collected from October 2015-January 2017. Susceptibility testing was performed and results were interpreted according to the EUCAST criteria.

Overall antibiotic resistance (ABR) rates to certain commonly used antibiotics, such as nitrofurantoin, fosfomycin and mecillinam were 1.2%, 1.3% and 4.1% (except for Germany that was missing result for mecillinam). Highest overall resistance rates were determined for ampicillin - 39.6%, trimethoprim -23.8%, trimethoprim/sulfamethoxazole -22.4%, amoxillin/clavulanic acid - 16.7% and ciprofloxacin - 15.1%, varying significantly among the countries. ESBL-production level was 8.7%. None of the isolates showed resistance to meropenem.

In most cases, low ABR rates were detected against the first line antibiotics recommended in national UTI treatment guidelines which give support to their future use. Our results also support the European Association of Urology guidelines stating that nitrofurantoin, fosfomycin and mecillinam are viable treatment options for uncomplicated UTI.

Journal of global antimicrobial resistance. 2018 Nov 14 [Epub ahead of print]

Sofia Ny, Petra Edquist, Uga Dumpis, Kirsi Gröndahl-Yli-Hannuksela, Julia Hermes, Anna-Maria Kling, Anja Klingeberg, Roman Kozlov, Owe Källman, Danuta O Lis, Monika Pomorska-Wesołowska, Māra Saule, Karin Tegmark Wisell, Jaana Vuopio, Ivan Palagin, NoDARS UTI study group

Public Health Agency of Sweden, Nobels väg 18, 17182 Solna, Stockholm, Sweden; Division of Clinical microbiology, Department of Laboratory Medicine, Karolinska Institutet, Alfred Nobels allé 10, 141 52 Huddinge, Stockholm, Sweden. Electronic address: ., Public Health Agency of Sweden, Nobels väg 18, 17182 Solna, Stockholm, Sweden. Electronic address: ., Pauls Stradins Clinical University Hospital, Pilsoņu iela 13, Zemgales priekšpilsēta, Rīga, LV-1002, Latvia. Electronic address: ., Institute of Biomedicine, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland. Electronic address: ., Robert Koch Institute, Seestraße 10, 13353, Berlin, Germany. Electronic address: ., Public Health Agency of Sweden, Nobels väg 18, 17182 Solna, Stockholm, Sweden. Electronic address: ., Robert Koch Institute, Seestraße 10, 13353, Berlin, Germany. Electronic address: ., Institute of Antimicrobial Chemotherapy of Smolensk State Medical University, Russian Federation PO Box N 5, Smolensk, 214019, Russia. Electronic address: ., Division of Clinical microbiology, Department of Laboratory Medicine, Karolinska Institutet, Alfred Nobels allé 10, 141 52 Huddinge, Stockholm, Sweden; Department of Communicable Disease Control and Prevention, Stockholm County Council, Magnus Ladulåsgatan 63A, 118 91 Stockholm, Sweden. Electronic address: ., Institute of Occupational Medicine and Environmental Health, Kościelna 13, 40-001 Sosnowiec, Poland. Electronic address: ., Institute of Occupational Medicine and Environmental Health, Kościelna 13, 40-001 Sosnowiec, Poland., Pauls Stradins Clinical University Hospital, Pilsoņu iela 13, Zemgales priekšpilsēta, Rīga, LV-1002, Latvia. Electronic address: ., Public Health Agency of Sweden, Nobels väg 18, 17182 Solna, Stockholm, Sweden. Electronic address: ., Institute of Biomedicine, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland. Electronic address: ., Institute of Antimicrobial Chemotherapy of Smolensk State Medical University, Russian Federation PO Box N 5, Smolensk, 214019, Russia. Electronic address: .

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