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.
Highlights
Less than a century after Sir Alexander Flemming’s discovery of Penicillinum notatum, the growing antimicrobial resistance (AMR) of most clinically relevant bacteria to antimicrobial agents represents a major challenge to the public health
Besides the associated morbidity and mortality, infections by multi-drug-resistant pathogens increase the pressure on heath care systems, too: An episode of a carbapenem-resistant Enterobacteriaceae urinary tract infection has been estimated to cost the health care system 66,000 USD [13]
Resistance to amoxicillin/clavulanic acid was above 10% for E. coli and Proteus spp. in most study years and ranged between 20.4% and 58.9% for Klebsiella spp. with a significant increasing trend (p = 0.041)
Summary
Less than a century after Sir Alexander Flemming’s discovery of Penicillinum notatum, the growing antimicrobial resistance (AMR) of most clinically relevant bacteria to antimicrobial agents represents a major challenge to the public health. AMR is caused by a mixture of factors, from improper antibiotics use in health care, to their unrestrained use in agriculture [1]. More than 2.8 million people acquire an antibiotic-resistant infection every year, resulting in more than 35,000 deaths; the corresponding figure for Europe is 33,000 annually [12]. Urinary tract infections (UTIs) belong among the most common types of infectious disease, accounting for approximately 150–250 million cases globally per year [14]. They are usually caused by Antibiotics 2020, 9, 630; doi:10.3390/antibiotics9090630 www.mdpi.com/journal/antibiotics
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