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Urinary Tract Infection in Male General Practice Patients: Uropathogens and Antibiotic Susceptibility

  • J.J. Koeijers
    Correspondence
    Reprint requests: J. J. Koeijers, M.D., Saint Elisabeth Hospital, Department of Internal Medicine, Breedestraat (o) 193, Curaçao, Netherlands Antilles
    Affiliations
    Departments of Internal Medicine/Department of Infectious Disease, Clinical Epidemiology and MTA, and Medical Microbiology, University Hospital Maastricht, Maastricht, The Netherlands; NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands; and Department of Internal Medicine, Saint Elisabeth Hospital, Curaçao, Netherlands Antilles
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  • A. Verbon
    Affiliations
    Departments of Internal Medicine/Department of Infectious Disease, Clinical Epidemiology and MTA, and Medical Microbiology, University Hospital Maastricht, Maastricht, The Netherlands; NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands; and Department of Internal Medicine, Saint Elisabeth Hospital, Curaçao, Netherlands Antilles
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  • A.G.H. Kessels
    Affiliations
    Departments of Internal Medicine/Department of Infectious Disease, Clinical Epidemiology and MTA, and Medical Microbiology, University Hospital Maastricht, Maastricht, The Netherlands; NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands; and Department of Internal Medicine, Saint Elisabeth Hospital, Curaçao, Netherlands Antilles
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  • A. Bartelds
    Affiliations
    Departments of Internal Medicine/Department of Infectious Disease, Clinical Epidemiology and MTA, and Medical Microbiology, University Hospital Maastricht, Maastricht, The Netherlands; NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands; and Department of Internal Medicine, Saint Elisabeth Hospital, Curaçao, Netherlands Antilles
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  • G. Donkers
    Affiliations
    Departments of Internal Medicine/Department of Infectious Disease, Clinical Epidemiology and MTA, and Medical Microbiology, University Hospital Maastricht, Maastricht, The Netherlands; NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands; and Department of Internal Medicine, Saint Elisabeth Hospital, Curaçao, Netherlands Antilles
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  • S. Nys
    Affiliations
    Departments of Internal Medicine/Department of Infectious Disease, Clinical Epidemiology and MTA, and Medical Microbiology, University Hospital Maastricht, Maastricht, The Netherlands; NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands; and Department of Internal Medicine, Saint Elisabeth Hospital, Curaçao, Netherlands Antilles
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  • E.E. Stobberingh
    Affiliations
    Departments of Internal Medicine/Department of Infectious Disease, Clinical Epidemiology and MTA, and Medical Microbiology, University Hospital Maastricht, Maastricht, The Netherlands; NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands; and Department of Internal Medicine, Saint Elisabeth Hospital, Curaçao, Netherlands Antilles
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      Objectives

      To evaluate uropathogens and their antibiotic susceptibility in male general practitioner (GP) patients presenting with an uncomplicated urinary tract infection (UTI).

      Material and Methods

      A population-based study was conducted among males, 18 years and older, general practice patients, who had symptoms indicative of an uncomplicated UTI. A UTI was defined as ≥103 colony-forming units/mL (CFU/mL). The etiology of the infection, antimicrobial susceptibility, and treatment strategies used by the GP were determined.

      Results

      Escherichia coli was most frequently isolated (48%), followed by other enterobacteriaceae (24%) and enterococci (9%). The etiology of infection was age-dependent; E. coli was more frequently isolated in younger patients and Pseudomonas aeruginosa in the elderly. The overall susceptibility rates were low for amoxicillin (63%) and trimethoprim (70%), and high for fluoroquinolones (91%) and amoxicillin-clavulanic acid (90%), which is similar to susceptibility rates in females with UTIs from the same population. Antibiotics were prescribed to 59% of the males with symptoms of UTI. Fluoroquinolones were given to 33% of the patients and trimethoprim-sulfamethoxazole to 24%. No difference in antibiotic prescription, nor in duration of therapy, was found between the different age groups.

      Conclusions

      In the male presenting with complaints of an acute uncomplicated UTI at the GP, E. coli, followed by other Gram-negative bacteria were the most frequently isolated uropathogens. Susceptibility rates in uncomplicated male and female UTIs were similar, indicating that data from UTI susceptibility studies in females from the same geographic region can be useful in the choice of empirical therapy in males.
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