{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T19:16:13Z","timestamp":1783192573323,"version":"3.54.6"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:00:00Z","timestamp":1783123200000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100013281","name":"Joint Programming Initiative on Antimicrobial Resistance","doi-asserted-by":"publisher","award":["JPIAMR_2017_P007"],"award-info":[{"award-number":["JPIAMR_2017_P007"]}],"id":[{"id":"10.13039\/100013281","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005416","name":"Research Council of Norway","doi-asserted-by":"publisher","award":["284253"],"award-info":[{"award-number":["284253"]}],"id":[{"id":"10.13039\/501100005416","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"publisher","award":["2017-05975"],"award-info":[{"award-number":["2017-05975"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007212","name":"Region V\u00e4stra G\u00f6taland","doi-asserted-by":"publisher","award":["VGFOUREG-855661"],"award-info":[{"award-number":["VGFOUREG-855661"]}],"id":[{"id":"10.13039\/100007212","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007212","name":"Region V\u00e4stra G\u00f6taland","doi-asserted-by":"publisher","award":["VGFOUREG-940739"],"award-info":[{"award-number":["VGFOUREG-940739"]}],"id":[{"id":"10.13039\/100007212","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007212","name":"Region V\u00e4stra G\u00f6taland","doi-asserted-by":"publisher","award":["VGFOUREG-994715"],"award-info":[{"award-number":["VGFOUREG-994715"]}],"id":[{"id":"10.13039\/100007212","id-type":"DOI","asserted-by":"publisher"}]},{"name":"ZonMw, the Netherlands","award":["549003002"],"award-info":[{"award-number":["549003002"]}]},{"DOI":"10.13039\/501100004442","name":"National Science Centre, Poland","doi-asserted-by":"publisher","award":["UMO-2017\/25\/Z\/NZ7\/03024"],"award-info":[{"award-number":["UMO-2017\/25\/Z\/NZ7\/03024"]}],"id":[{"id":"10.13039\/501100004442","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Norwegian Surveillance System for Antimicrobial Drug Resistance"},{"name":"Gidske and Peter Jacob S\u00f8rensens Research Trust"},{"name":"Norwegian Research Fund for General Practice"},{"name":"Department of General Practice, Institute of Health and Society at the University of Oslo"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To describe microbiological findings during asymptomatic and symptomatic phases in older women with recurrent urinary tract infections (rUTIs), to evaluate whether antimicrobial resistance patterns of Escherichia coli among methenamine hippurate users differ from untreated controls, and to explore prescription patterns of UTI antibiotics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a descriptive study alongside a multinational randomized controlled trial (ImpresU). Women aged \u226570\u2005years with rUTIs were recruited from general practice in Norway, Sweden, Poland and the Netherlands between December 2019 and June 2022. Participants were randomized to methenamine hippurate 1\u2005g or placebo twice daily for 6 months, followed by a 6 month follow-up period. Urinary samples were collected at baseline (asymptomatic) and during acute UTIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 281 women. A dominating uropathogen \u2265105\u2005cfu\/mL was detected in 29% of the baseline urine samples. Of the 178 urinary cultures taken at acute UTIs, 163 (92%) had bacterial growth, of which a minority (10%) were reported as mixed flora. E. coli was most frequently detected both at baseline and in acute UTIs (present in any concentration in 32% versus 60% of urine samples), with highest resistance to amoxicillin (36% versus 43%), trimethoprim (16% versus 22%) and amoxicillin\/clavulanate (12% versus 16%). ESBL-producing E. coli at baseline were rare (4.1%). Phylogenetic subgroup B2 was the most frequent E. coli phylotype at baseline (52%). No relevant differences in antimicrobial resistance rates were found between methenamine hippurate users and controls. Narrow-spectrum antibiotics were widely prescribed, and guideline adherence was high.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Physicians should be aware that 29% of older women with rUTIs in the community may have significant bacterial findings in their urine during asymptomatic phases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jacamr\/dlag121","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T11:53:50Z","timestamp":1781178830000},"source":"Crossref","is-referenced-by-count":0,"title":["Microbiological findings, antibiotic resistance rates and prescription practices for older women with recurrent urinary tract infections: a descriptive study alongside a multinational randomized controlled trial (ImpresU)"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8645-5836","authenticated-orcid":false,"given":"Silje Rebekka","family":"Heltveit-Olsen","sequence":"first","affiliation":[{"name":"The Antibiotic Centre for Primary Care, Department of General Practice, Institute of Health and Society, University of Oslo , P.O. Box 1130 Blindern, Oslo 0318 ,","place":["Norway"]},{"name":"Department of Medical Microbiology, Vestfold Hospital Trust , T\u00f8nsberg ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"Grude","sequence":"additional","affiliation":[{"name":"The Antibiotic Centre for Primary Care, Department of General Practice, Institute of Health and Society, University of Oslo , P.O. Box 1130 Blindern, Oslo 0318 ,","place":["Norway"]},{"name":"Department of Medical Microbiology, Vestfold Hospital Trust , T\u00f8nsberg ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Egill","family":"Snaebj\u00f6rnsson Arnljots","sequence":"additional","affiliation":[{"name":"General Practice\/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , Box 453, Gothenburg SE-405 30 ,","place":["Sweden"]},{"name":"FoUUI-Centrum S\u00f6dra \u00c4lvsborg, Research, Education, Development & Innovation, Primary Health Care, Region V\u00e4stra G\u00f6taland, Sweden , Sven Eriksonsplatsen 4, Bor\u00e5s SE-503 38 ,","place":["Sweden"]},{"name":"N\u00e4rh\u00e4lsan Heimdal Primary Health Care Centre , Steng\u00e4rdsgatan 22, Bor\u00e5s 50334, Sverige"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9889-509X","authenticated-orcid":false,"given":"P\u00e4r-Daniel","family":"Sundvall","sequence":"additional","affiliation":[{"name":"General Practice\/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , Box 453, Gothenburg SE-405 30 ,","place":["Sweden"]},{"name":"Allm\u00e4nmedicinskt Centrum, Research, Education, Development & Innovation, Primary Health Care, Region V\u00e4stra G\u00f6taland, Sweden , Guldhedsgatan 5A, Gothenburg SE-413 20 ,","place":["Sweden"]},{"name":"Centrum for Antibiotic Resistance Research (CARe), University of Gothenburg , Gothenburg ,","place":["Sweden"]},{"name":"N\u00e4rh\u00e4lsan Sandared Primary Health Care Centre , Strandv\u00e4gen 11, Sandared 518 32 ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9183-3072","authenticated-orcid":false,"given":"Ronny","family":"Gunnarsson","sequence":"additional","affiliation":[{"name":"General Practice\/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , Box 453, Gothenburg SE-405 30 ,","place":["Sweden"]},{"name":"Allm\u00e4nmedicinskt Centrum, Research, Education, Development & Innovation, Primary Health Care, Region V\u00e4stra G\u00f6taland, Sweden , Guldhedsgatan 5A, Gothenburg SE-413 20 ,","place":["Sweden"]},{"name":"Centrum for Antibiotic Resistance Research (CARe), University of Gothenburg , Gothenburg ,","place":["Sweden"]},{"name":"Cairns Clinical School, College of Medicine and Dentistry, James Cook University , PO Box 6811, Cairns, QLD 4870 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7524-2085","authenticated-orcid":false,"given":"Anna","family":"Kowalczyk","sequence":"additional","affiliation":[{"name":"Centre for Family and Community Medicine, the Faculty of Health Sciences, The Medical University of Lodz , Lodz 90-419 ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9204-5518","authenticated-orcid":false,"given":"Maciej","family":"Godycki-Cwirko","sequence":"additional","affiliation":[{"name":"Centre for Family and Community Medicine, the Faculty of Health Sciences, The Medical University of Lodz , Lodz 90-419 ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5122-0079","authenticated-orcid":false,"given":"Tamara N","family":"Platteel","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht , Universiteitsweg 100, Utrecht 3584 CG ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wim G","family":"Groen","sequence":"additional","affiliation":[{"name":"Department of Medicine for Older People, Amsterdam UMC, Vrije Universiteit Amsterdam , De Boelelaan 1117, Amsterdam 1081 HV ,","place":["The Netherlands"]},{"name":"Amsterdam Public Health Research Institute, Aging & Later Life , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8725-5959","authenticated-orcid":false,"given":"Sara Sofia","family":"Lith\u00e9n","sequence":"additional","affiliation":[{"name":"The Antibiotic Centre for Primary Care, Department of General Practice, Institute of Health and Society, University of Oslo , P.O. Box 1130 Blindern, Oslo 0318 ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Sundvall","sequence":"additional","affiliation":[{"name":"FoUUI-Centrum S\u00f6dra \u00c4lvsborg, Research, Education, Development & Innovation, Primary Health Care, Region V\u00e4stra G\u00f6taland, Sweden , Sven Eriksonsplatsen 4, Bor\u00e5s SE-503 38 ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nahid","family":"Karami","sequence":"additional","affiliation":[{"name":"Centrum for Antibiotic Resistance Research (CARe), University of Gothenburg , Gothenburg ,","place":["Sweden"]},{"name":"Institute of Biomedicine, Department of Infectious Diseases, University of Gothenburg , Gothenburg ,","place":["Sweden"]},{"name":"Sahlgrenska University Hospital, Department of Clinical Microbiology, Region V\u00e4stra G\u00f6taland , Gothenburg 41345 ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theo J M","family":"Verheij","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht , Universiteitsweg 100, Utrecht 3584 CG ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cees M P M","family":"Hertogh","sequence":"additional","affiliation":[{"name":"Department of Medicine for Older People, Amsterdam UMC, Vrije Universiteit Amsterdam , De Boelelaan 1117, Amsterdam 1081 HV ,","place":["The Netherlands"]},{"name":"Amsterdam Public Health Research Institute, Aging & Later Life , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten","family":"Lindb\u00e6k","sequence":"additional","affiliation":[{"name":"The Antibiotic Centre for Primary Care, Department of General Practice, Institute of Health and Society, University of Oslo , P.O. Box 1130 Blindern, Oslo 0318 ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"\u00c5hr\u00e9n","sequence":"additional","affiliation":[{"name":"Centrum for Antibiotic Resistance Research (CARe), University of Gothenburg , Gothenburg ,","place":["Sweden"]},{"name":"Institute of Biomedicine, Department of Infectious Diseases, University of Gothenburg , Gothenburg ,","place":["Sweden"]},{"name":"Swedish Strategic Program against Antimicrobial Resistance (Strama), Region V\u00e4stra G\u00f6taland , Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1806-3811","authenticated-orcid":false,"given":"Sigurd","family":"H\u00f8ye","sequence":"additional","affiliation":[{"name":"The Antibiotic Centre for Primary Care, Department of General Practice, Institute of Health and Society, University of Oslo , P.O. 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