Current Antibiotic Resistance Trends of Uropathogens in Central Europe: Survey from a Tertiary Hospital Urology Department 2011–2019

Abstract

Monitoring of pathogen resistance profiles is necessary to guide empirical antibiotic therapy before culture and sensitivity results become available. The aim of this study was to describe current antibiotic resistance patterns of five most frequent causative uropathogens in a Department of Urology of a tertiary referral centre in Central Europe over a period of nine years. The Hospital Department of Clinical Microbiology database was used to extract data on all positive urine samples from inpatients in the Department of Urology between 2011 and 2019. Numbers of susceptible and resistant isolates per year were calculated for five most frequent uropathogens: Escherichia coli, Enterococcus spp., Klebsiella spp., Pseudomonas aeruginosa, and Proteus spp. Antimicrobial agents selected for the survey included: ampicillin, amoxicillin/clavulanic acid, piperacillin/tazobactam; cefuroxime, cefotaxime, ceftazidime and cefepime; ciprofloxacin and ofloxacin; gentamicin and amikacin; ertapenem, meropenem and imipenem; trimethoprim-sulfamethoxazole (co-trimoxazole), nitrofurantoin, colistin, and vancomycin. High resistance rates of Gram-negative uropathogens were demonstrated to most common antimicrobials, with statistically significant increasing or decreasing trends in some cases. No carbapenem-resistant Enterobacteriaceae were isolated. Vancomycin-resistant Enterococcus spp. strains were rare in our population.

Antibiotic Resistance of Uropathogens Isolated from Patients Hospitalized in District Hospital in Central Poland in 2020

“…In this study, the second frequently isolated bacteria were K. pneumoniae rods (13.7%), which is in accordance with the results reported by other authors [ 17 , 18 , 23 ]. In our study, E. faecalis (9.3%) and E. faecium (6.2%) were less commonly isolated from positive urinary cultures, similarly as reported by Mahony [ 21 ], Hrbacek [ 24 ], and Woldemariam [ 20 ]. Our study showed that E. coli was significantly more often isolated from women.…”

“…In our study, 26.2% of E. coli isolates were ESBL producers, about six times more than in previous studies (4.4%) of uropathogenic E. coli isolates (2007–2008) from the same hospital [ 45 ]. Hrbacek et al [ 24 ] showed that between 2011 and 2019 in a Department of Urology of tertiary referral centers in Central Europe, 8.7% of E. coli strains produced ESBL. In the USA in 2017, prevalence of ESBL phenotypes of E. coli was 15.7%, and ESBL isolates showed co-resistance to many oral agents [ 46 ].…”

Current antibiotic resistance patterns of rare uropathogens: survey from Central European Urology Department 2011–2019

“…Similar to our previous related work [ 25 ], urinary cultures from the Department of Clinical Microbiology electronic database between January 2011 and December 2019 were searched for those caused by the following genera: Acinetobacter , Citrobacter , Enterobacter , Morganella , Providencia , Serratia and Stenotrophomonas . Urine cultures may have originated from spontaneously voided midstream samples, aseptic catheterisation during theatre procedures, indwelling catheters, suprapubic catheters, nephrostomy tubes and uretero-ileostomies.…”

“…The method used for culture and susceptibility testing has been described elsewhere [ 25 ]. Briefly, uncentrifuged urine was inoculated with a 0.01 ml loop on blood and UriSelect chromogenic agar (Bio-Rad, Berkeley, CA, USA) in a semi-quantitative dilution method.…”

Chemical Characterization and Antibacterial Activity of Essential Oil of Medicinal Plants from Eastern Serbia

“…Escherichia coli is the most dominant pathogen causing urinary tract infections [ 19 , 20 , 21 ] as well as foodborne illnesses [ 22 , 23 , 24 ], while Staphylococcus aureus is the most common cause for foodborne [ 25 , 26 ], skin and soft tissue infectious diseases [ 27 , 28 , 29 ]. However, over the past decade, the changing pattern of resistance in E. coli and S. aureus has emphasized the need for new antimicrobial agents [ 30 , 31 , 32 ].…”