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In European countries, antimicrobial resistance has been
monitored in selected bacteria from humans since 1998
through the European Antimicrobial Resistance Surveillance
System (EARSS)

Funded by the European Commission, EARSS is an

international network of national surveillance system
intended to collect comparable and reliable resistance data.

The purpose of EARSS is to document variations in

antimicrobial resistance over time and place and to provide
the basis for the assessment and the effectiveness of
prevention programs and policy decision .
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The importance of co-selection is illustrated by sulfamethoxazole resistance in Sweden

an Denmark (16% vs 21%);the frequencies are very similar despite the fact that
sulphonamides were abandoned in Sweden in the 1970s but are still extensively used
in the treatment of UTIs in Denmark. However, trimethoprim is used extensively in
Sweden and co-selects for sulphonamide resistance.
A striking finding in the ECO-SENS
survey is the low incidence of
resistance to agents used only
in lower UTI
Meticillinam
Nitrofurantoin
Fosfomycin
Used for >25 years and exibit equally
low levels of resistance in countries
that have used them extensively and in
countries that have not used them.
The fact that resistance to
gentamicin was almost non-
existent in community E.coli is of
no help in the treatment of
UTI, but means that primary
septicaemia originating from
UTIs with E.coli can be treated as
effectively with gentamicin today
as it was 30 years ago.
Eco-sens project shows that
resistance to any agent is
associated with  




      


  
   
  
The Question is
Have all microorganisms,
responsible for UTI, become more
resistant
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Are there any solutions
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This study revealed no obvious trend in the prevalence of drug ²
resistant community-acquired UTI in single community.
Prevalence at any time was influenced by a small number of E.coli
clonal groupes.

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