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Abstract

Introduction

Empirical therapy for the treatment of urinary tract infections should be tailored to the current distribution and susceptibility of potential pathogens to ensure optimal treatment.

Aim

We aimed to provide an up-to-date overview of the epidemiology and susceptibility of Enterobacterales isolated from urine in Germany.

Methods

We retrospectively analysed antimicrobial susceptibility data from 201,152 urine specimens collected between January 2016 and June 2021 from in- and outpatients. Multiple logistic regression analysis was used to evaluate the association between year of investigation and antibiotic resistance, adjusted for age, sex and species subgroup. Subgroup analyses were performed for midstream urine samples obtained from (i) female outpatients aged 15 to 50 years, (ii) female outpatients older than 50 years and (iii) male outpatients.

Results

Resistance rates of less than 20% were observed for nitroxoline (3.9%), fosfomycin (4.6%), nitrofurantoin (11.7%), cefuroxime (13.5%) and ciprofloxacin (14.2%). Resistance to trimethoprim/sulfamethoxazole (SXT) (20.1%), amoxicillin-clavulanic acid (20.5%), trimethoprim (24.2%), pivmecillinam (29.9%) and ampicillin (53.7%) was considerably higher. In the subgroup of outpatient women aged 15–50 years, resistance rates were generally lower. Resistance rates of all antibiotics decreased from 2016 to 2021. Multiple logistic regression revealed the lowest adjusted odds ratio (ORadj) of 0.838 (95% confidence interval (CI): 0.819–0.858; p < 0.001) for pivmecillinam and the highest ORadj of 0.989 (95% CI: 0.972–1.007; p = 0.226) for nitrofurantoin.

Conclusions

Resistance has generally decreased over the past years, independent of sex, age and causative pathogen. Our data provide an important basis for empirical antibiotic recommendations in various settings and patient collectives.

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A corrected article has been published for this content:
Author’s correction for Euro Surveill. 2023;28(19)
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2023-05-11
2024-04-27
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2023.28.19.2200568
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Antimicrobial resistance of clinical Enterobacterales isolates from urine samples, Germany, 2016 to 2021
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Carolin+Stoltidis-Claus&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Stoltidis-Claus Carolin</a>, <a href="/search?value1=Kerstin+Daniela+Rosenberger&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rosenberger Kerstin Daniela</a>, <a href="/search?value1=Falitsa+Mandraka&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mandraka Falitsa</a>, <a href="/search?value1=Xenia+Quante&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Quante Xenia</a>, <a href="/search?value1=J%C3%B6rg+Gielen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gielen Jörg</a>, <a href="/search?value1=Dennis+Hoffmann&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hoffmann Dennis</a>, <a href="/search?value1=Hilmar+Wisplinghoff&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Wisplinghoff Hilmar</a>, <a href="/search?value1=Nathalie+Jazmati&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jazmati Nathalie</a></span>. Antimicrobial resistance of clinical Enterobacterales isolates from urine samples, Germany, 2016 to 2021. <a href="/content/ecdc">Euro Surveill.</a> 2023;28(19):pii=2200568. <a href="https://doi.org/10.2807/1560-7917.ES.2023.28.19.2200568" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2023.28.19.2200568</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 12 Jul 2022;&nbsp;&nbsp; <span class="generated">Accepted</span>: 30 Nov 2022 </span> </p>
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