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Occurrence and susceptibility rates among urinary tract infection pathogens from Europe: a seven-year report from the SENTRY Antimicrobial Surveillance Program (1997–2000, 2003)

Abstract number: 1733_629

Moet G., Stilwell M., Jones R.

Objectives: To report the occurrence and susceptibility (S) rates for pathogens causing urinary tract infection (UTI) isolated from medical centres in Europe, Turkey, and Israel. The S rates were compared by CLSI and EUCAST breakpoints. The SENTRY Antimicrobial Surveillance Program was utilised as the platform for collecting urine culture isolates during 5 years out of 10 year period that the programme has been in existence.

Methods: A total of 4,507 strains (50 consecutive, non-duplicate per site) were collected from 42 medical centres in 19 countries in Europe, Turkey and Israel (1997–2000, 2003). During the 5 years 31 locations participated in 3 or more years. All isolate identifications were confirmed and S testing performed in a central laboratory using reference broth microdilution methods (M7-A7) and interpretive criteria of CLSI and EUCAST (2006). ESBL phenotype rates were as determined by CLSI criteria.

Results: The 5 most frequent pathogens accounted for 83.3% of the total CA-UTI and the top 7 for 90.0%. These 7 pathogens displayed little change in occurrence rates over the 7 year period. Escherichia coli remained the dominant UTI pathogen at nearly 50% while enterococci showed a slight decrease from 11.7 to 10.1%. Variations in 1999 were greater due to only 9 participating sites (small sample size). Among commonly isolated Enterobacteriaceae, carbapenems were the most active agents ranging from 99.1% to 100.0% S; lower S was noted for ciprofloxacin (77–89%) and trimethoprim/sulfamethoxazole (T/S; 63–78%). Ceftazidime S rates for Klebsiella, E. coli, and Proteus mirabilis were 80.7, 97.2, 95.5% (CLSI) and lower at 76.9, 94.7, 92.5% (EUCAST), respectively. ESBL phenotype rates were 24.0, 5.3, and 7.2% for the same organism groups. Polymyxin B was active against Pseudomonas aeruginosa at 99% S, followed by carbapenems and piperacillin/tazobactam at 84% and amikacin at 83%. Vancomycin, teicoplanin, and linezolid remained active against enterococci (99% S).

Variation of rank order in SENTRY Program UTI pathogens by year for Europe

RankOrganismAll years19971998199920002003
1E. coli2,175(48.3)505(51.0)548(48.0)68(39.5)361(46.1)693(48.8)
2Enterococci510(11.3)116(11.7)127(11.1)23(13.4)100(12.8)144(10.1)
3Klebsiella spp.445(9.9)83(8.4)120(10.5)25(11.6)69(8.8)153(10.8)
4P. aeruginosa355(7.9)65(6.6)91(8.0)16(9.3)71(9.1)112(7.9)
5P. mirabilis265(5.9)52(5.2)70(6.1)3(1.7)56(7.2)84(5.9)
6Enterobacter spp.194(4.3)49(4.9)36(3.2)11(6.4)33(4.2)65(4.6)
7Indole + Proteus spp.109(2.4)21(2.1)31(2.7)5(2.9)27(3.1)28(2.0)
Total4,5079911,142172a7831,419
aSmall sample.

Conclusions: This comprehensive report from the SENTRY Program covering 7 years of UTI sampling in Europe, reports minor variation in the most common pathogens between the sample intervals but with significant S differences noted among monitored countries. Emerging resistance is limiting the usefulness of commonly prescribed UTI agents including T/S and FQ, forcing reliance on more potent parenteral broad-spectrum agents and the additional problems inherent in their use.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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