Abstract：
To optimize antibiotic treatment and decrease antibiotic resistance, national treatment guidelines are available for urinary tract infections (UTIs) in general practice. The usefulness of these guidelines in risk areas for antimicrobial resistance such as cross border regions or areas with dense agriculture, is unknown.
Midstream urine samples from women with symptoms of acute UTI visiting general practitioners (GPs) in the Westland area, a dense agriculture area, were microbiologically analysed, and patient characteristics, symptoms, previous and present antibiotic treatment were collected. The National Nivel data were used as reference for antibiotic resistance.
Of 310 women with symptoms of uncomplicated UTI, 247 (80%) had a culture proven E. coli UTI. Empirical antibiotic therapy was prescribed to 148 patients (48%) in total; in 7% of women with a negative and 52% with a positive urine culture. Having more than one symptom was associated with the prescription of antibiotics; travel history or previous antibiotic use for UTI were not. The isolated uropathogens were susceptible to the empiric antibiotic therapy in 98% of patients. Resistance to co-amoxiclav was higher (22%) than reported in the national data of 2004 (12%), 2009 (13%) and 2014 (9%), as was the prevalence of extended spectrum β-lactamase (ESBL): 3.4% in our study versus 0.1%, 1% and 2.2% in the national data respectively.
The presence of environmental and socio-demographic risk factors for antibiotic resistance did not influence the empiric choice nor susceptibility for antibiotics advised by the national guidelines in women with uncomplicated UTI.
Midstream urine samples from women with symptoms of acute UTI visiting general practitioners (GPs) in the Westland area, a dense agriculture area, were microbiologically analysed, and patient characteristics, symptoms, previous and present antibiotic treatment were collected. The National Nivel data were used as reference for antibiotic resistance.
Of 310 women with symptoms of uncomplicated UTI, 247 (80%) had a culture proven E. coli UTI. Empirical antibiotic therapy was prescribed to 148 patients (48%) in total; in 7% of women with a negative and 52% with a positive urine culture. Having more than one symptom was associated with the prescription of antibiotics; travel history or previous antibiotic use for UTI were not. The isolated uropathogens were susceptible to the empiric antibiotic therapy in 98% of patients. Resistance to co-amoxiclav was higher (22%) than reported in the national data of 2004 (12%), 2009 (13%) and 2014 (9%), as was the prevalence of extended spectrum β-lactamase (ESBL): 3.4% in our study versus 0.1%, 1% and 2.2% in the national data respectively.
The presence of environmental and socio-demographic risk factors for antibiotic resistance did not influence the empiric choice nor susceptibility for antibiotics advised by the national guidelines in women with uncomplicated UTI.
摘要：
优化抗生素治疗，降低抗生素耐药性，在一般实践中，国家治疗指南可用于尿路感染（UTI）。这些指南在抗菌素耐药性风险领域的有用性，如跨境地区或农业密集地区，是未知的。
在Westland地区就诊的有急性UTI症状的女性全科医生（GP）的中游尿液样本，一个密集的农业区，进行了微生物学分析，和患者特征，症状,收集以前和现在的抗生素治疗。NationalNivel数据被用作抗生素耐药性的参考。
310名女性出现不复杂的UTI症状，247（80％）具有培养证明的大肠杆菌UTI。总共为148名患者（48％）开了经验性抗生素治疗；7％的阴性女性和52％的尿培养阳性女性。有一个以上的症状与抗生素的处方有关;旅行史或以前使用UTI的抗生素没有。在98％的患者中，分离出的尿路病原体对经验性抗生素治疗敏感。对co-amoxiclav的耐药性（22％）高于2004年国家数据（12％），2009年（13%）和2014年（9%），以及超广谱β-内酰胺酶（ESBL）的患病率：在我们的研究中3.4%对0.1%，全国数据分别为1%和2.2%。
抗生素耐药性的环境和社会人口统计学危险因素的存在并不影响无并发症UTI女性的经验性选择和国家指南建议的抗生素敏感性。
在Westland地区就诊的有急性UTI症状的女性全科医生（GP）的中游尿液样本，一个密集的农业区，进行了微生物学分析，和患者特征，症状,收集以前和现在的抗生素治疗。NationalNivel数据被用作抗生素耐药性的参考。
310名女性出现不复杂的UTI症状，247（80％）具有培养证明的大肠杆菌UTI。总共为148名患者（48％）开了经验性抗生素治疗；7％的阴性女性和52％的尿培养阳性女性。有一个以上的症状与抗生素的处方有关;旅行史或以前使用UTI的抗生素没有。在98％的患者中，分离出的尿路病原体对经验性抗生素治疗敏感。对co-amoxiclav的耐药性（22％）高于2004年国家数据（12％），2009年（13%）和2014年（9%），以及超广谱β-内酰胺酶（ESBL）的患病率：在我们的研究中3.4%对0.1%，全国数据分别为1%和2.2%。
抗生素耐药性的环境和社会人口统计学危险因素的存在并不影响无并发症UTI女性的经验性选择和国家指南建议的抗生素敏感性。
