Acta clinica Belgica · 2025
Overview and resistance profiles of isolated pathogens in women with uncomplicated urinary tract infection in primary care.
СтатьяНазвание и аннотация: Перевод в очереди
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Vanderpoorten Loic, Vandevelde Siebe, De Corte Lien, Holvoet Jasper, Vandevelde Laura, Thys Camille, Thyssen Eline, Veekens Lieselot, Touré Fatou, Boelens Jerina, Heytens Stefan
Аннотация
OBJECTIVE: In primary care, urinary tract infections (UTIs) are typically treated empirically, based on the likelihood of specific pathogens and their susceptibility profiles. The goal of this study was to reassess empirical treatment guidelines by comparing he current distribution and susceptibility of uropathogens.
METHOD: Distribution and susceptibility were analyzed and compared with data from three previous surveys conducted in Belgium over the past 25 years. Between August 2020 and February 2022, 137 general practitioners (GPs) collected midstream urine samples from adult female patients with specific cystitis symptoms. The dipslide was inoculated and sent for microbiological analysis.
RESULTS: Of the 237 enrolled patients, 201 (85%) had positive cultures. Escherichia coli (74,6%) was the most frequently isolated uropathogen, followed by Staphylococcus saprophyticus (8%), Enterococcus faecalis (6,6%), and Klebsiella pneumoniae (3,3%), confirming the results of the 1995, 2005, and 2015 surveys. The susceptibility of E. coli in 2020 remained 100% for nitrofurantoin and fosfomycin. For ampicillin, there was gradual increase of resistance with a susceptibility in 2020 of 53,5%. The susceptibility rates were 97,5% for levofloxacin and 83,6% for trimethoprim-sulfamethoxazole. Contrary to previous surveys, pivmecillinam was included in the 2020 survey with a susceptibility of 94,8%.
CONCLUSION: Over a 25-year period, the distribution and antimicrobial susceptibility of uropathogens associated with uncomplicated UTIs remained stable. For the first time in Belgium, we assessed E. coli susceptibility to pivmecillinam and found excellent outcomes, suggesting that pivmecillinam could be considered equivalent to standard treatments for uncomplicated UTIs.
METHOD: Distribution and susceptibility were analyzed and compared with data from three previous surveys conducted in Belgium over the past 25 years. Between August 2020 and February 2022, 137 general practitioners (GPs) collected midstream urine samples from adult female patients with specific cystitis symptoms. The dipslide was inoculated and sent for microbiological analysis.
RESULTS: Of the 237 enrolled patients, 201 (85%) had positive cultures. Escherichia coli (74,6%) was the most frequently isolated uropathogen, followed by Staphylococcus saprophyticus (8%), Enterococcus faecalis (6,6%), and Klebsiella pneumoniae (3,3%), confirming the results of the 1995, 2005, and 2015 surveys. The susceptibility of E. coli in 2020 remained 100% for nitrofurantoin and fosfomycin. For ampicillin, there was gradual increase of resistance with a susceptibility in 2020 of 53,5%. The susceptibility rates were 97,5% for levofloxacin and 83,6% for trimethoprim-sulfamethoxazole. Contrary to previous surveys, pivmecillinam was included in the 2020 survey with a susceptibility of 94,8%.
CONCLUSION: Over a 25-year period, the distribution and antimicrobial susceptibility of uropathogens associated with uncomplicated UTIs remained stable. For the first time in Belgium, we assessed E. coli susceptibility to pivmecillinam and found excellent outcomes, suggesting that pivmecillinam could be considered equivalent to standard treatments for uncomplicated UTIs.