Update on Urinary Tract Infection Antibiotic Resistance-A Retrospective Study in Females in Conjunction with Clinical Data

Cristian Mareș; Răzvan-Cosmin Petca; Răzvan-Ionuț Popescu; Aida Petca; Răzvan Mulțescu; Cătălin Andrei Bulai; Cosmin Victor Ene; Petrișor Aurelian Geavlete; Bogdan Florin Geavlete; Viorel Jinga

doi:10.3390/life14010106

Update on Urinary Tract Infection Antibiotic Resistance-A Retrospective Study in Females in Conjunction with Clinical Data

Life (Basel). 2024 Jan 9;14(1):106. doi: 10.3390/life14010106.

Authors

Cristian Mareș^{1

2}, Răzvan-Cosmin Petca^{1

3}, Răzvan-Ionuț Popescu^{1

3}, Aida Petca^{4

5}, Răzvan Mulțescu², Cătălin Andrei Bulai^{1

2}, Cosmin Victor Ene^{1

2}, Petrișor Aurelian Geavlete^{1

2}, Bogdan Florin Geavlete^{1

2}, Viorel Jinga^{1

3

6}

Affiliations

¹ Department of Urology, "Carol Davila" University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania.
² Department of Urology, "Saint John" Clinical Emergency Hospital, 13 Vitan-Barzesti Str., 042122 Bucharest, Romania.
³ Department of Urology, "Prof. Dr. Th. Burghele" Clinical Hospital, 20 Panduri Str., 050659 Bucharest, Romania.
⁴ Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania.
⁵ Department of Obstetrics and Gynecology, Elias University Emergency Hospital, 17 Mărăști Blvd., 050474 Bucharest, Romania.
⁶ Medical Sciences Section, Academy of Romanian Scientists, 050085 Bucharest, Romania.

Abstract

Urinary tract infections (UTIs) represent a frequent pathology among the female population that has become more and more difficult to treat in the past decade, considering the increase in antibiotic resistance-a serious global public health problem. A cross-sectional retrospective study was conducted for six months to report an update regarding the rates of resistance and susceptibility of uropathogens necessary for optimal treatment. A total of 5487 patients were screened, of which 524 (9.54%) were female patients who met the criteria for inclusion in the study. Escherichia coli was the most common pathogen, representing 290 cases (55.34%), followed by Enterococcus spp. 82 (15.64%). Escherichia coli presented the highest resistance to amoxicillin-clavulanic acid (R = 33.1%), followed by trimethoprim-sulfamethoxazole (R = 32.41%) and levofloxacin (R = 32.06%). The highest sensitivity rates were observed for fosfomycin (S = 96.55%), followed by imipenem (S = 93.1%). Enterococcus spp. showed the highest resistance to levofloxacin (R = 50.0%), followed by penicillin (R = 39.02%). The highest sensitivity was observed for fosfomycin (S = 90.24%), linezolid (S = 89.02%), and nitrofurantoin (S = 86.58%). The second most frequent Gram-negative uropathogen was represented by Klebsiella spp., which had the highest resistance to amoxicillin-clavulanic acid (R = 35.89%), followed by levofloxacin (R = 25.64) and trimethoprim-suflamethoxazole (R = 24.35%). The most frequently associated pathology was an episode of UTI in the previous year, followed by diabetes and chronic kidney disease. Antibiotic resistance is a serious problem for all clinicians who treat UTIs. An up-to-date knowledge of antibiotic resistance rates is a major necessity to stop its evolution. Overall, the highest resistance rates were observed for aminopenicillins, fluoroquinolones, and trimethoprim-sulfamethoxazole. The best susceptibility rates were observed for fosfomycin, nitrofurantoin, and carbapenems. Our report aims to guide clinicians whenever they are forced to prescribe antibiotics empirically.

Keywords: AMR; E. coli; Enterococcus; Klebsiella; UTIs; antimicrobial resistance; urinary tract infections; uropathogens.

Grants and funding

This research received no external funding. The publication of this paper was supported by the University of Medicine and Pharmacy “Carol Davila” Bucharest, Romania, through the institutional program “Publish not Perish”.