Urinary tract infections (UTIs) are common in primary care and often treated with antibiotics. To ensure effective treatment, it’s important to understand the bacteria causing these infections and how they respond to antibiotics. The development of resistance to these treatments, called antimicrobial resistance or AMR is a global concern. This study in Belgium aims to determine which bacteria are responsible for uncomplicated UTIs and how they might resist common treatments.
Surveillance is crucial for shaping healthcare policies, enhancing quality and guiding research. While surveillance of antimicrobial resistance (AMR) in hospitals is well-established, a similar approach for outpatient (ambulatory) care is crucial. The SARPRIC-UTI project, focusing on uncomplicated UTIs, plays a pivotal role in this context.
UTIs are a common reason for outpatient antimicrobial prescriptions. Effective empirical treatment is possible, but understanding uropathogens and antibiotic susceptibility is essential for guideline development.
Initiatives since 2017 within the European Antimicrobial Resistance Surveillance System for Belgium (EARS-BE) aimed to explore outpatient AMR trends by collecting data on AMR from urinary isolates. Despite the advantage of working with existing laboratory data and reducing the workload of general practitioners, passive surveillance has limitations, such as the lack of information on isolate origin and associated clinical diagnosis. Samples often represent a selected population with risk factors, recurrent infections, or complicated UTIs, limiting the applicability of results to current outpatient treatment guidelines. Moreover, there’s a low participation rate of non-hospital laboratories, hindering nationally representative surveillance for local guidance. Before investing in efforts to increase non-hospital laboratory participation in passive surveillance, it’s essential to assess its representativeness in primary care. Therefore, active surveillance through an observational study is necessary.
Previous Belgian studies led by Dr. Stefan Heytens of the University of Ghent in 1995, 2005, and 2015 were limited in sample size and regional focus, hindering national comparisons. The SARPRIC-UTI study, detailed in the protocol, aims to collect 2000 urine samples from women over 18 with uncomplicated UTI symptoms. General practitioners and laboratories collaborate in gathering clinical data, bacterial culture results, and antimicrobial susceptibility tests. This data will be sent to Sciensano for analysis. Data collection runs from December 2023 to December 2024 or until 2000 samples are obtained.