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Table 1 Basic characteristics and general resistance findings of the final 17 scientific papers (in alphabetical order)

From: Antibiotic resistance in primary care in Austria - a systematic review of scientific and grey literature

Author Sampling setting and report of results Sampling location Years of resistance testing Total no. of isolates (Austria) Bacteria Antibiotics General Resistance findings
Auer et al 2010 [30] Hospital (2%) and primary health care (98%) - results reported together Salzburg, Upper Austria, Styria (Austria) 2004-2008 100 ESBL-producing E. coli FOF, MEL, ETP, NIT, SXT, GEN, CIP 3% FOF, 6% NIT, 15% MEL, 0% ETP, 22% GEN, 73% SXT, 78% CIPa
Badura et al 2007 [37] Hospital and primary health care- results reported together Southeast Austria 1997-2006 690,967 collectively E. coli, S. aureus, Klebsiella spp. Various for each bacteria The data show insignificant changes in prevalence of MRSA and vancomycin-resistant enterococci in southeast Austria during the past decade (1997-2006) but an alarming increase of ESBL-producing E. coli isolates in recent years.
Buxbaum et al 2003 [32] Hospital and primary health care- results reported together Austria 2001-2002 542 S. pneumoniae, PEN, TEL, ERY, CLR, 2.2% PEN, 0% TEL, 8.5% ERY, 10.3% CLR, 7% AZM
     223 S. pyogenes, same 0% PEN, 0% TEL, 8% ERY, 6.7% CLR, 8.1% AZM
     183 S. aureus, same 73.2% PEN, 2.2 TEL, 17% ERY, 16.4% CLR, 16.4% AZM
     67 H. influenzae AMP instead of PEN 1.5% AMP, 0% TEL, ERY, CLR, AZM
Canton et al 2002 [21] Primary health care 25 countries worldwide incl. Austria 1999-2000 25 S.pyogenes, ERY, LVX, PEN, TEL No special results for Austria. But compared to the other countries Austria had one of the lowest resistance rates.
     20 S.aureus TEL 0% TEL
Cizman 2003 [22] Primary health care 21 countries in Europe incl. Austria 1997-1999 1997-2000 n/a H. influenzae, PEN The antibiotic resistance rates were set in correlation with the mean national outpatient consumption. Compared to the other countries Austria had a low total outpatient consumption of 13.80 DDD/1000 inhabitants/day in 1997 and a penicillin resistance rate of S. pneumoniae of 12.4%. With the consumption of macrolides Austria was ranked in the middle field with a resistance rate for S. pneumoniae of 11.4%.
      S. pneumoniae, PEN, ERY  
      S. pyogenes ERY  
Felmingham et al 2002 [23] Primary health care 25 countries worldwide incl. Austria 1999-2000 57 S. pneumoniae PEN, ERY 5.3% PEN, 12.3% ERY Compared to the other countries Austria had one of the lowest resistance rates.
Graninger 2003 [24] Primary health care 16 European countries incl. Austria and Canada 1999-2000 n/a E. coli n/a The publication highlights the effectiveness of MEL compared to other antibiotics
Hoban et al 2002 [25] Primary health care 25 countries worldwide incl. Austria 1999-2000 40 19 H.influenzae M. catarrhalis n/a 2.5% ß-lactamase + 89.5% ß-lactamase +
Hönigl et al 2010 [33] Hospital (63%) and primary health care (37%)- results reported together Southeast Austria 1997-2008 1997: (n = 113) 2008: (n = 218) S. pneumoniae PEN, ERY, CLI, TET, SXT, quinolones 1997: 3.5% ERY, 1.8% CLI, 1.8% TET, 7.1% SXT, 0.9% QUIN 2008: 14.7% ERY, 10.6% CLI, 11% TET, 9.2% SXT, 0.5% quinolones
Kahlmeter 2003 [26] Primary health care 17 countries in Europe incl. Austria 1999-2000 126 E. coli AMP, AMC, MEC, CFR, TMP, SUL, SXT, NAL, CIP, NIT, FOF, GEN Compared to the other 16 European countries Austria had one of the lowest resistance rates for E. coli: 17.5% AMP, 2.4% AMC, 1.6% MEC, 0.8% CFR, 9.5% TMP, 25.4% SUL, 9.5% SXT, 2.4% NAL, 0% CIP, 0.8% NIT, 0% FOF, 0.8% GEN
Kahlmeter et al 2003 [29] Primary health care 17 countries in Europe including Austria 1999-2000 126 E. coli AMP, AMC, MEC, CFR, TMP, SUL, SXT, NAL, CIP, NIT, FOF, GEN 17.5% AMP, 2.4% AMC, 1.6 MEC, 0.8% CFR, 9.5% TMP, 25.4 SUL, 9.5% SXT, 2.4% NAL, 0% CIP, 0.8% NIT, 0% FOF, 0.8 GEN
Krziwanek et al 2008 [35] Hospital and primary health care- results reported together Austria 1996-2006 1,439 MRSA n/a In Carinthia, 73% of all MRSA belonged to ST228. In the Austrian region "Salzkammergut", the proportion of ST5 increased from 26% in 2004 to 89% in 2006. In eastern Upper Austria and western Lower Austria, the ST8 Austrian clone was predominant.
Krziwanek et al 2009 [36] Hospital and primary health care- results reported together Upper Austria 2006-2008 1,098 MRSA n/a Out of the 1,098 MRSA samples from humans, 21 were MRSA type ST398 that is usually associated with animals. Most of these 21 patients were farmers (n = 16). Increasing prevalence from 1.3% in 2006 to 2.5% in 2008 shows emergence of MRSA ST398 in humans in Austria.
Prelog et al 2008 [31] Hospital and primary health care- results reported together Western Austria 2006 2,042 E. coli n/a 20 out of the 2,042 E. coli isolates demonstrated alleles encoding CTX-M enzymes belonging to phylogentic group 1.
Schito et al 2000 [27] Primary health care 14 countries in Europe incl. Austria 1992-1998 185 S. pneumoniae PEN, ERY 4.8% PEN, 11.4%
     153 H. influenzae DOX, SXT, CIP 1.3% DOX, 13.7% SXT, 0.0% CIP
     n/a M. catarrhalis n/a  
Schito et al 2002 [34] Hospital and primary health care- results reported together Italy, Spain, Austria 1999-2000 3,593 collectively in all three countries S. pneumoniae, M. catherrralis, H. influenzae K. pneumoniae S. pyogenes, S. aureus AMP, AMC, CEC, CXM, CFM, CTB, CPD, AZM, CLR for all bacteria The results show a substantial prevalence of macrolide resistance of the bacteria analysed in Italy, Spain and Austria.
Schito et al 2009 [28] Primary health care 9 European countries including Austria and in addition Brazil 2003-2006 3,018 collectively in all nine countries E. coli, K. pneumoniae, P. mirabilis, S. saphrophyticus AMP, AMC, MEC, CFX, NAL, CIP, SXT, NIT, FOF Mean resistance rates for E.coli between 2003 and 2006 for Austria were e.g.: 48.3% AMP 8.1% NAL and 29.0% SXT. Compared to the other countries Austria with 48.3% resistance against AMP had one of the highest resistance rates; against the other antibiotics one of the lowest rates.
  1. Abbr.: FOF, fosfomycin; MEL, pivmecillinam; ETP, ertapenem; NIT, nitrofurantoin; GEN, gentamicin; SXT, trimethoprim-sulfamethoxazole; CIP, ciprofloxacin; PEN, penicillin; ERY, erythromycin; CLI, clindamycin; TET, tetracycline; AMP, ampicillin; AMC, co-amoxiclav; MEC, mecillinam; CFR, cefadroxil; TMP, trimethoprim; SUL, sulfamethoxazole; NAL, nalidixic acid; DOX, doxycyclin; CXM, cefuroxime; CEC, cefaclor; CFM, cefixime; CTB, ceftibuten; CPD, cefpodoxime; AZM, azithromycin; CLR, clarithromycin; LVX, levofloxacin
  2. n/a: Data not described in the publication
  3. a: Resistance data include intermediate susceptible isolates