title: Resistance profiles of urinary tract infections in general practice--an observational study.
abstract: BACKGROUND
  Guideline recommendations on therapy in urinary tract infections are based on antibiotic resistance rates. Due to a lack of surveillance data, little is known about resistance rates in uncomplicated urinary tract infection (UTI) in general practice in Germany. In a prospective observational study, urine cultures of all women presenting with urinary tract infections in general practice were analysed. Resistance rates against antibiotics recommended in German guidelines on UTI are presented.
  
  
  METHODS
  In a prospective, multi-center observational study general practitioner included all female patients ≥ 18 years with clinically suspected urinary tract infection. Only patients receiving an antibiotic therapy within the last two weeks were excluded.
  
  
  RESULTS
  40 practices recruited 191 female patients (mean age 52 years; range 18-96) with urinary tract infections. Main causative agent was Escherichia coli (79%) followed by Enterococcus faecalis (14%) and Klebsiella pneumoniae (7.3%).Susceptibility of E.coli as the main causative agent was highest against fosfomycin and nitrofurantoin, with low resistance rates of 4,5%; 2,2%. In 17,5%, E.coli was resistant to trimethoprim and in 8,5% to ciprofloxacin.
  
  
  CONCLUSIONS
  Resistance rates of uropathogens from unselected patients in general practice differ from routinely collected laboratory data. These results can have an impact on antibiotic prescribing and treatment recommendations.
authors.affiliation: Department for Health Services Research, Institute for Public Health and Nursing Science, Universität Bremen, Bremen, Germany. schmiemann@uni-bremen.de
authors.forename: Guido
authors.initials: G
authors.lastname: Schmiemann
authors.forename: Ildikó
authors.initials: I
authors.lastname: Gágyor
authors.forename: Eva
authors.initials: E
authors.lastname: Hummers-Pradier
authors.forename: Jutta
authors.initials: J
authors.lastname: Bleidorn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002939:Ciprofloxacin / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D004927:Escherichia coli Infections / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D005578:Fosfomycin / Q000627:therapeutic use; D058006:General Practice; D005858:Germany; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy* / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009582:Nitrofurantoin / Q000627:therapeutic use; D011446:Prospective Studies; D014295:Trimethoprim / Q000627:therapeutic use; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D005578:Fosfomycin; D002939:Ciprofloxacin; D009582:Nitrofurantoin; D014295:Trimethoprim