Article Figures & Data
Figures
- Figure 1. Flowchart of the survey process. SHI = statutory health insurance.
- Figure 2. List of the 20 most frequently tested antibiotics. Antibiotics tested, n = 106. aAdditional antibiotic not listed in the questionnaire.
Tables
Characteristic Total, N = 258, n (%) Performing susceptibility tests, n (%) Yes, n = 106 No, n = 152 Federal statea 253 101 152 Baden-Wuerttemberg 11 (4.3) 9 (8.9) 2 (1.3) Bavaria 20 (7.9) 13 (12.9) 7 (4.6) Berlin 10 (4.0) 1 (1.0) 9 (5.9) Brandenburg 17 (6.7) 4 (4.0) 13 (8.6) Hamburg 12 (4.7) 5 (5.0) 7 (4.6) Hesse 21 (8.3) 8 (7.9) 13 (8.6) Lower Saxony 27 (10.7) 12 (11.9) 15 (9.9) Mecklenburg-Western Pomerania 19 (7.5) 5 (5.0) 14 (9.2) North Rhine-Westphalia 52 (20.6) 20 (19.8) 32 (21.1) Rhineland-Palatinate 13 (5.1) 4 (4.0) 9 (5.9) Saarland 4 (1.6) 2 (2.0) 2 (1.3) Saxony 20 (7.9) 8 (7.9) 12 (7.9) Saxony-Anhalt 11 (4.3) 5 (5.0) 6 (3.9) Schleswig-Holstein 7 (2.8) 2 (2.0) 5 (3.3) Thuringia 9 (3.6) 3 (3.0) 6 (3.9) Participation by medium 258 106 152 Telephone 198 (76.7) 48 (45.3) 150 (98.7) Email 51 (19.8) 49 (46.2) 2 (1.3) Fax 9 (3.5) 9 (8.5) 0 (0.0) a n = 5 practices did not provide federal state.
- Table 2. Characteristics of laboratories performing susceptibility testing for outpatient urinary tract infections
Characteristic n (%)a Testing standard used, n = 105b Clinical and Laboratory Standards Institute 5 (4.8) European Committee on Antimicrobial Susceptibility Testing 101 (96.2) National Antimicrobial Susceptibility Testing Committee 59 (56.2) Other 1 (1.0) Bacterial count limit used, n = 106 b 10² CFU/ml 16 (15.1) 10³ CFU/ml 54 (50.9) 10⁴ CFU/ml 21 (19.8) Use of bacterial count ≥105 CFU/ml 5 (4.7) Bacterial count limit based on inhibiting test 5 (4.7) Bacterial count limit based on detection of leukocytes 4 (3.8) Bacterial count limit based on the type or number of pathogens that are detected 3 (2.8) Bacterial count limit based on the sender’s requirements 2 (1.9) Deviation from the previously listed standard of susceptibility tests, n = 104 Yes 84 (80.8) No 20 (19.2) Description of situations in which deviating susceptibility tests are performed, n = 82b Detection of (multidrug-)resistant pathogens 56 (68.3) Multidrug-resistant gram-negative bacteria 31 (37.8) Detection of other pathogens 8 (9.8) Sender request 26 (31.7) Special patient groups 11 (13.4) Inpatients 5 (6.1) Children 3 (3.7) Desired information accompanying the urine sample, n = 101 b Clinical information or special features 57 (56.4) Pregnancy 13 (12.9) Immunosuppression 8 (7.9) Antibiotic (pre)treatment 56 (55.4) Information on the material or type of urine sample 46 (45.5) Catheter urine 20 (19.8) Diagnosis or suspected diagnosis 29 (28.7) Leukocyte detection or leukocyturia 19 (18.8) Exact date of urine collection 8 (7.9) Other 4 (4.0) Estimated proportion of urine samples with indication of the type of urine, n = 99 Mean (SD) 63.7 (37.0) Median (IQR) 80.0 (20.0–95.0) Estimated proportion of urine samples with indication of pretreatment, n = 96 Mean (SD) 21.3 (23.4) Median (IQR) 10.0 (5.0–30.0) Estimated proportion of urine samples with information on concomitant diseases, n = 100 Mean (SD) 21.5 (24.5) Median (IQR) 10.0 (5.0–30.0) aUnless otherwise stated. bMultiple answers possible. IQR = interquartile range. SD = standard deviation.
- Table 3. Antibiotic testing for outpatient urinary tract infections in German laboratories (N = 106)10,11
Category n (%)a Number of antibiotics tested per laboratory 6–9 antibiotics tested 16 (15.1) 10–13 antibiotics tested 40 (37.7) 14–17 antibiotics tested 40 (37.7) ≥18 antibiotics tested 10 (9.4) Mean (SD) 13.1 (3.6) Median (IQR) 13.0 (11.0–15.0) Number of antibiotics tested per laboratory recommended in the guidelinesb 0 recommended antibiotics tested 1 (0.9) 1 recommended antibiotic tested 4 (3.8) 2 recommended antibiotics tested 11 (10.4) 3 recommended antibiotics tested 15 (14.2) 4 recommended antibiotics tested 47 (44.3) 5 recommended antibiotics tested 28 (26.4) Mean (SD) 3.8 (1.1) Median (IQR) 4.0 (3.0–5.0) aUnless otherwise stated. bThe two valid guidelines10,11 at the time of data collection recommend as first-line treatment for uncomplicated urinary tract infections fosfomycin trometamol, nitrofurantoin, nitroxoline, pivmecillinam, and trimethoprim, with local resistance rates of <20%. IQR = interquartile range. SD = standard deviation.
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Urinary tract infection in outpatients in Germany: a cross-sectional study of diagnostics and susceptibility testing in medical laboratories
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