Spectrum and Antibiotic Resistance of Uropathogens in Romanian Females

Abstract

Urinary tract infections (UTIs) in women represent a common bacteriological finding, with negligible recent and consistent research on antimicrobial resistance (AMR) in the female population. We designed a retrospective study to observe the incidence of frequent uropathogens and their resistance rates to common antibiotics. We elaborated multicenter research in three different teaching hospitals in Romania, analyzing 13,081 urine samples, of which 1588 met the criteria of inclusion. Escherichia coli (58.37%) was the most frequent Gram-negative uropathogen, presenting high resistance rates to levofloxacin (R = 29.66%), amoxicillin–clavulanic ac. (R = 14.13%), and ceftazidime (R = 6.68%). We found good sensitivity to imipenem and meropenem (both 98.16%), amikacin (S = 96.0%), and fosfomycin (S = 90.39%). The second most prevalent uropathogen was Klebsiella (16.93%), with the highest resistance quota to amoxicillin–clavulanic ac. (R = 28.62%), levofloxacin and nitrofurantoin (both R = 15.61%), and ceftazidime (R = 15.24%), and good sensitivity to imipenem (S = 93.93%), meropenem (S = 91.91%), and amikacin (S = 88.47%). Enterococcus (13.35%) was the most encountered Gram-positive pathogen. It proved the highest resistance to levofloxacin (R = 32.07%), penicillin (R = 32.07%), and ampicillin (R = 14.62%) and good sensitivity to vancomycin (S = 91.98%), fosfomycin (S = 94.4%), and nitrofurantoin (S = 89.15%). Considering the lack of recent and consistent data on this topic, we find our survey a valuable starting research study in this area with high significance for an accurate clinical approach.

Heterogeneity of Antibiotics Multidrug-Resistance Profile of Uropathogens in Romanian Population

“…Bacterial culture, the identification of uropathogens, and the antibiotic susceptibility test used were previously described in more detail [ 3 , 4 , 11 ].…”

“…Most UTIs are treated on ambulatory patients [ 2 ]. However, the increasing resistance to the first-line antibiotic treatment [ 3 , 4 , 5 ] and the rising quota of this condition [ 6 ] have urged the research of new lines of therapy. In practice, we must combine updated data on uropathogens’ resistance profiles and sensibility rates of antimicrobial agents used in the treatment of UTIs.…”

Urinary Tract Infections in Elderly Patients: A 10-Year Study on Their Epidemiology and Antibiotic Resistance Based on the WHO Access, Watch, Reserve (AWaRe) Classification

“…To facilitate the selection of appropriate antimicrobial therapy, it has been encouraged to develop hospital antibiograms based on available local microbiological data, especially for infections where empirical therapy is prevalent [ 21 ]. Nevertheless, the available data on the specific epidemiological characteristics of UTIs in elderly patients is scarce, often evaluated only as a consortium of larger population data [ 22 ]. Consequently, the aim of this study was to report on the resistance rates and epidemiology of UTIs affecting patients aged ≥ 65 years in the southern region of Hungary during a 10-year (2008–2017) surveillance period.…”

Chemical hemorrhagic cystitis: Diagnostic and therapeutic pitfalls (Review)

“…Urinalysis and urine culture are required to exclude infectious cystitis (36). In spite of its noninfectious feature, CC can coexist with infectious cystitis.…”