Uropathogens’ Antibiotic Resistance Evolution in a Female Population: A Sequential Multi-Year Comparative Analysis

Abstract

Urinary Tract Infections (UTIs) represent a common finding among females and an important basis for antibiotic treatment. Considering the significant increase in antibiotic resistance during the last decades, this study retrospectively follows the incidence of uropathogens and the evolution of resistance rates in the short and medium term. The current study was conducted at the “Prof. Dr. Th. Burghele” Clinical Hospital, including 1124 positive urine cultures, in three periods of four months between 2018 and 2022. Escherichia coli was the most frequent uropathogen (54.53%), followed by Klebsiella spp. (16.54%), and Enterococcus spp. (14.59%). The incidence of UTIs among the female population is directly proportional to age, with few exceptions. The highest overall resistance in Gram-negative uropathogens was observed for levofloxacin 30.69%, followed by ceftazidime 13.77% and amikacin 9.86%. The highest resistance in Gram-positive uropathogens was observed for levofloxacin 2018-R = 34.34%, 2020-R = 50.0%, and 2022-R = 44.92%, and penicillin 2018-R = 36.36%, 2020-R = 41.17%, and 2022-R = 37.68%. In Gram-negative uropathogens, a linear evolution was observed for ceftazidime 2018-R = 11.08%, 2020-R = 13.58%, and 2022-R = 17.33%, and levofloxacin 2018-R = 28.45%, 2020-R = 33.33%, and 2022-R = 35.0%. The current knowledge dictates the need to continuously assess antimicrobial resistance patterns, information that is necessary for treatment recommendations. The present study aims to determine the current situation and the evolution trends according to the current locoregional situation.

Decline in ESBL Production and Carbapenem Resistance in Urinary Tract Infections among Key Bacterial Species during the COVID-19 Pandemic

“…Another local study in Jeddah showed an increase in resistance among Enterobacteriaceae from 8% to 13% [ 42 ]. In contrast to previous studies, a Romanian study highlighted a stable sensitivity to carbapenems among E. coli , K. pneumoniae , and P. aeruginosa over the observation period of 2018–2022 [ 43 ]. The decreases observed in our study, notably in E. coli and K. pneumoniae , sharply contrast with these rising global trends, suggesting that the pandemic may have influenced these patterns, possibly due to changes in antibiotic prescribing or infection control measures.…”

Pre- and Post-COVID-19 Antimicrobial Resistance Pattern of Pathogens in an Intensive Care Unit

“…To our knowledge, no similar studies have been published examining the possible changes in antimicrobial resistance in Romania, in the pre- and post-COVID-19 periods. Only one study investigated possible changes in uropathogen resistance in female patients before and during the COVID-19 pandemic [ 16 , 17 ]. The study found the greatest increase in resistance in Klebsiella spp.…”

Prevalence and Antimicrobial Sensitivity Patterns of Uropathogens in Wad Medani, Sudan: A Three Years, Cross-Sectional Study

“…18 Furthermore, the results of our study contradict those of a study conducted on Romanian female patients, which revealed that linezolid, levofloxacin, and nitrofurantoin were the most sensitive drugs for S. aureus. 34 Moreover, a study conducted in Eritrea reported that vancomycin 26.1%, rifampin 14.5%, and chloramphenicol 21.5% were the most sensitive drugs, while penicillin 95% and oxacillin 76.9% were the most resistant drugs. 22 However, a study conducted in Madinah, Saudi Arabia, revealed that the most sensitive drugs were vancomycin, nitroxoline, and trimethoprim/sulfamethoxazole, while the most resistant drugs were penicillin and ampicillin.…”

“…17 However, in a study conducted on Romanian female patients, the most sensitive drugs for GNB were imipenem and meropenem, while the most resistant drugs were levofloxacin, ceftazidime, and amikacin. 34 This difference could be linked to the difference in study patients and settings.…”