Antimicrobial susceptibility patterns of community-acquired uropathogenic , Dublin 2010-2022.

BACKGROUND

is a common cause of urinary tract infections. Due to the increase in antimicrobial resistance (AMR) and global differences in antimicrobial susceptibility data, routine assessment of local antimicrobial susceptibility patterns is necessary to guide the selection of appropriate empirical therapy. The aim of this study was to evaluate the antimicrobial susceptibility patterns of community-acquired uropathogenic within a catchment area in Dublin over a 13 year period, 2010-2022.

METHODS

All mid-stream urine samples received from local general practitioners in which there was significant bacteriuria during the study period, 2010-2022, were included in the analysis. Antimicrobial susceptibility testing was performed by disc diffusion as per the European Committee on Antimicrobial Susceptibility Testing recommendations.

RESULTS

An average of 11 407 urine samples per month had significant bacteriuria, with accounting for an average of 67 % of those. Overall AMR rates were highest for ampicillin (53.9 %), followed by trimethoprim (32.4 %), gentamicin (18.6 %), co-amoxiclav (16.5 %), ciprofloxacin (12.3 %), cephalexin (8.3 %), cefpodoxime (6.8 %) and nitrofurantoin (2 %). While rates appeared grossly static, statistically significant reduced resistance rates were noted for co-amoxiclav (r=-0.95; =<0.001), cephalexin prior to 2019 (r=-0.783; =0.013) and trimethoprim (r=-0.639; =0.019), with a statistically significant increase in non-susceptibility to cefpodoxime (r=0.802; =0.001).

CONCLUSIONS

In order to generate efficient empirical antimicrobial prescribing guidelines, knowledge of region-specific contemporaneous antimicrobial susceptibility patterns is pivotal. Our findings support the use of nitrofurantoin or cephalexin as empirical antimicrobial therapy within our setting.