Bacterial growth and antimicrobial resistance in urinary isolates among men with lower UTI in Swedish primary healthcare: retrospective data over a 4 year period.

BACKGROUND

, the most common bacterium causing urinary tract infections (UTIs), is increasingly reported as resistant to multiple antibiotics. Swedish surveillance data from hospital and primary health care (PHC) report a 17%-19% prevalence of resistance to ciprofloxacin in from urine cultures in men over 20 years of age. Surveillance data may include nosocomial infections. However, few studies have described resistance in in men with community-acquired UTI in PHC. We aimed to describe the microbiological results, including antibiotic resistance in , in men with lower UTI (LUTI) attending PHC.

METHODS

In this retrospective study based on information from electronic medical records, we included patients from 289 PHC centres. For all men aged 18-79 years diagnosed with LUTI in PHC from January 2012 to December 2015, we extracted data on age, UTI diagnosis and results from urine cultures.

RESULTS

A total of 17 987 episodes of lower UTI were identified. was detected in 62% of positive cultures and 63% of detected isolates were susceptible to all tested antimicrobials. Resistance in to the first-choice antibiotics pivmecillinam and nitrofurantoin were 2% and 1%, respectively. Resistance to ciprofloxacin was 9%, and to trimethoprim it was 17%.

CONCLUSIONS

Resistance levels for ciprofloxacin in among men with LUTI in PHC were lower than in surveillance data. The results of this study point to the importance of surveillance of resistance in urine samples from patients with LUTI in PHC in order to choose the right empirical antibiotic treatment.