Kornfält Isberg Helena, Sundqvist Martin, Melander Eva, Beckman Anders, Hedin Katarina
Department of Clinical Sciences, Family Medicine Malmö, Lund University, Malmö, Sweden.
Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
JAC Antimicrob Resist. 2024 Dec 26;7(1):dlae214. doi: 10.1093/jacamr/dlae214. eCollection 2025 Feb.
, 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.
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.
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%.
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.
大肠杆菌是引起尿路感染（UTIs）最常见的细菌，对多种抗生素耐药的报道日益增多。瑞典医院和初级卫生保健（PHC）的监测数据显示，20岁以上男性尿液培养中的大肠杆菌对环丙沙星的耐药率为17%-19%。监测数据可能包括医院感染。然而，很少有研究描述初级卫生保健机构中社区获得性尿路感染男性患者的大肠杆菌耐药情况。我们旨在描述在初级卫生保健机构就诊的下尿路感染（LUTI）男性患者的微生物学结果，包括大肠杆菌的抗生素耐药情况。
在这项基于电子病历信息的回顾性研究中，我们纳入了来自289个初级卫生保健中心的患者。对于2012年1月至2015年12月在初级卫生保健机构诊断为LUTI的所有18-79岁男性，我们提取了年龄、UTI诊断和尿液培养结果的数据。
共确定了17987例下尿路感染发作。在62%的阳性培养物中检测到大肠杆菌，63%检测到的大肠杆菌分离株对所有测试抗菌药物敏感。大肠杆菌对首选抗生素匹美西林和呋喃妥因的耐药率分别为2%和1%。对环丙沙星的耐药率为9%，对甲氧苄啶的耐药率为17%。
初级卫生保健机构中LUTI男性患者的大肠杆菌对环丙沙星的耐药水平低于监测数据。本研究结果表明，监测初级卫生保健机构中LUTI患者尿液样本的耐药情况对于选择正确的经验性抗生素治疗非常重要。
