Multiple Drug-resistant Strains Research Articles

Reactivation of Multidrug-Resistant HSV-1 in a Post-Allogenic Hematopoietic Stem Cell Transplant Patient: Dynamic Detection of the Rare A605V Mutation by Next-Generation Sequencing.

We present an immunocompromised patient with a multiresistant herpes simplex virus-1 reactivation with a rare mutation (A605V) in the viral DNA polymerase gene. Next-generation sequencing suggests the presence of multiple drug-resistant strains before treatment and altered ratios during treatment, affecting the clinical response to aciclovir and foscarnet.

Phenotypic, molecular detection, and Antibiotic Resistance Profile (MDR and XDR) of Aeromonas hydrophila isolated from Farmed Tilapia zillii and Mugil cephalus

In the present study, Aeromonas hydrophila was isolated from Tilapia zillii and Mugil cephalus samples collected during different seasons from various Suez Canal areas in Egypt. The prevalence of A. hydrophila, virulence genes, and antibiotic resistance profile of the isolates to the commonly used antibiotics in aquaculture were investigated to identify multiple drug resistance (MDR) and extensive drug-resistant (XDR) strains. In addition, a pathogenicity test was conducted using A. hydrophila, which was isolated and selected based on the prevalence of virulence and resistance genes, and morbidity of natural infected fish. The results revealed that A. hydrophila was isolated from 38 of the 120 collected fish samples (31.6%) and confirmed phenotypically and biochemically. Several virulence genes were detected in retrieved A. hydrophila isolates, including aerolysin aerA (57.9%), ser (28.9%), alt (26.3%), ast (13.1%), act (7.9%), hlyA (7.9%), and nuc (18.4%). Detection of antibiotic-resistant genes revealed that all isolates were positive for blapse1 (100%), blaSHV (42.1%), tetA (60.5%), and sul1 (42.1%). 63.1% of recovered isolates were considered MDR, while 28.9% of recovered isolates were considered XDR. Some isolates harbor both virulence and MDR genes; the highest percentage carried 11, followed by isolates harboring 9 virulence and resistance genes. It could be concluded that the high prevalence of A. hydrophila in aquaculture species and their diverse antibiotic resistance and virulence genes suggest the high risk of Aeromonas infection and could have important implications for aquaculture and public health.

Exploitation of mangliculous marine fungi, Amarenographium solium, for the green synthesis of silver nanoparticles and their activity against multiple drug-resistant bacteria

Abstract The green synthesis pathway for silver nanoparticles (AgNPs) used in bacterial treatment is regarded as crucial because of its cost-effectiveness, nontoxicity, and eco-friendliness. During the present work, the mangliculous marine fungi Amarenographium solium isolated from the Arabian Gulf Coast of Saudi Arabia were utilized for the synthesis of AgNP, through the bio-reduction of aqueous silver nitrate (AgNO3) solution. The success in AgNP synthesis was visually identified by the development of dark brown color in the cell-free filtrate and was further confirmed by ultraviolet–visible spectroscopy, which showed a peak at 425 nm. The AgNPs produced were further characterized using X-ray diffraction data analysis that proved the bioreduction of silver to 20 nm, and transmission electron microscopy revealed the formation of well-dispersed spherical nanoparticles with an average mean size of 12 nm. The optimization reaction parameters of temperature, pH, and metal salt concentration were carried out and resulted in a combination of 30°C, 7 and 1.5 mM, respectively, for rapid and maximum yield production. The antibacterial activity of the produced nanoparticles was evaluated using the two-fold microdilution method and showed a minimum inhibitory concentration of 9.375 μg/mL of AgNP against multiple drug-resistant bacterial strains.

Assessment of antibiotic resistant profile of coliform and Staphylococcus spp. isolated from milk from Kathmandu valley

Antimicrobial resistance (AMR) among milk pathogens is increasing, which is a serious threat to consumers’ health. Therefore, this study aims to assess the current antibiotic profile of coliforms and Staphylococcus spp. in milk samples. For this, thirty milk samples were collected from various locations in Kathmandu district. Isolation and enumeration were done on selective media using streak-plate and pour-plate techniques, respectively. Antibiotic susceptibility testing (AST) was done by the Kirby-Bauer disk diffusion method. A total of 48 bacteria were isolated, of which 31 were coliform and 17 Staphylococcus spp. Among the coliforms, Klebsiella spp. (n=17, 54.84%) was the most predominant in both raw (n=12, 70.6%) and pasteurized milk (n=5, 29.4%), followed by E. coli and Citrobacter spp. While for Staphylococcus spp., 15 (88.24%) were S. aureus and 2 (11.76%) were coagulase negative Staphylococcus (CONS). S. aureus was dominant in raw milk (n=13) rather than pasteurized milk (n=2). The AST of coliforms showed higher resistance towards ampicillin (96.75%), followed by cefoxitin, ciprofloxacin, nalidixic acid, nitrofurantoin, piperacillin, co-trimoxazole, ceftriaxone, chloramphenicol, and amikacin in descending order. In the case of S. aureus, higher resistance was observed for penicillin G (100.00%), followed by cefoxitin, ampicillin, ceftriaxone, tetracycline, ciprofloxacin, and amikacin. Further, 12 (70.53%) S. aureus were confirmed as methicillin-resistant S. aureus (MRSA). And a total of 10 (32.25%) coliforms and 9 (52.95%) S. aureus were identified as multiple drug resistant (MDR) strains. Thus, it can be concluded that antibiotic resistance among milk isolates of the coliform and Staphylococcus spp. is highly prevalent, and these can be a potential source of incurable milk-borne infections. Thus, routine assessment of microbial quality as well as AMR surveillance should be done on milk isolates to ensure the safety of consumer’s health.

Comparative Antimicrobial Activity of Amikacin and Gentamicin on Clinically Important Bacteria

Aminoglycosides discovered 80 years ago are still the drug of choice for combating a range of infections, including those caused by multiple drug-resistant (MDR) strains of bacteria. These bactericidal antibiotics are nephrotoxic and ototoxic and often not permitted for therapeutic use in animals and birds.

Anti-malarial and haematological evaluation of the ethanolic, ethyl acetate and aqueous fractions of Chromolaena odorata

Malaria is a global health challenge with endemicity in sub-Saharan Africa, where there are multiple drug-resistant strains and limited access to modern health care facilities, especially in rural areas. Studies indicate that African traditional medicine could make a substantial contribution to the reduction of malaria-related deaths and achievement of universal health coverage (UHC), particularly in these regions. Thus, this study evaluated the curative antimalarial effects of Chromolaena odorata leaf extract using mouse model. Forty-five (45) albino mice weighing between 18 and 22 g were grouped into nine groups of 5 animals each. Animals in groups 2–9 were infected with the chloroquine-resistant strain of Plasmodium berghei, while animals in groups 3–9 were subsequently treated with 10 mg/kg chloroquine, a combination of 1.4 mg/kg artemether and 8.75 mg/kg lumefantrine (Coartem), and varying concentrations of the fraction from the aqueous leaf extract of C. odorata at day 3 post-infection. The findings from this study indicate that treatment with 400 mg/kg of the ethanolic fraction of the crude extract resulted in a significant decrease in parasite load (97.6%), which was comparable to the activities of the conventional drugs chloroquine (98.6%) and Coartem (98.8%). The ethyl acetate and ethanolic fractions at 400 mg/kg also ameliorated the significant alterations in the red blood cells, white blood cells, and platelets of the infected animals. The high antimalarial activity displayed by the ethanolic fraction could be due to the presence of quercetin and kaempferol, as detected by high performance liquid chromatography (HPLC) analysis. The findings suggest that the fractions from C. odorata could serve as an alternative source of malaria therapy, particularly in sub-Saharan Africa.

Efficacy of photodynamic therapy in an experimental mice tuberculosis model

The objective: to study the efficacy of antimicrobial photodynamic therapy (APDT) using hydroxyaluminum phthalocyanine (Photosens) as a photosensitizer in the experimental model of tuberculosis infection in mice.Subjects and Methods. Balb/cmice were infected with the multiple drug resistant (MDR) strain of M. tuberculosis Beijing BO/W148. APDT with hydroxyaluminum phthalocyanine and red laser light exposure were started on Day 45. A total of 4 sessions of APDT on the projection of both lungs, liver and spleen were performed. On Day 60, the therapeutic eff ect of APDTwas assessed by evaluation of severity of mycobacterial load and specific granulomatous infiltration in the lungs, liver and spleen. The absorption of light energy of laser radiation by the chest and abdominal walls, as well as tissues of lungs, liver and spleen was determined by photometry using afluovisor.Results. The tissues of the experimental animal retain a significant amount of light energy, however, the residual value of light transmission is sufficient to provide a pronounced therapeutic effect which manifests itself as a significant decrease of mycobacterial load and specific inflammatory process in all the studied internal organs.Conclusion. APDT may be an effective tool to treat some forms of tuberculous infection including those caused by M. tuberculosis with MDR.

Antimicrobial Resistance Profile of <i>Escherichia coli</i> and <i>Salmonella</i> Isolated from Meat Sold in Sokoto Central Market, Sokoto State

This study was designed to isolate and identify Escherichia coli and Salmonella spp. from raw-meat samples, on retail in the Sokoto central market and test their susceptibility to commonly prescribed antibiotics. Meat samples (n=40) were randomly collected from selected retail spots within the Sokoto metropolis, pre-enriched in buffered peptone water and incubated at 37°C for 12 hours. Pre- enriched samples were streaked on MacConkey agar and incubated at 37°C for 24 hours. The isolates were subjected to a series of biochemical tests for characterization and subsequent antimicrobial sensitivity testing using the disc diffusion method. Of the 40 samples collected, 7 were contaminated with E. coli and Salmonella spp. Antibiotic sensitivity testing showed that E. coli and Salmonella spp isolates were both resistant to chloramphenicol (10µg), ampicillin (30µg), amoxicillin (30µg), cefuroxime (30µg) and norfloxacin (10µg) In conclusion, this study showed that E. coli and salmonella spp. isolates from raw beef sold in Sokoto open market were multiple drug resistant strains which underscores a public health concern.

S2064 An Unusual Cause of Cholangitis by Multiple Drug Resistant Strain of Salmonella typhi: A Case-Based Literature Review

S2064 An Unusual Cause of Cholangitis by Multiple Drug Resistant Strain of Salmonella typhi: A Case-Based Literature Review

Effects of silver nanoparticles on multiple drug-resistant strains of Staphylococcus aureus from periodontal infection: An alternative approach for antimicrobial therapy

Introduction and Aim: Most cases of periodontitis are associated with microorganisms. The Gram positive bacteria Staphylococcus aureus is considered as one of the important organisms associated with periodontal infections. This study investigated the effect of silver nanoparticles as well as the antiseptic agent chlorhexidine on multi-drug resistant S. aureus isolated from periodontal infections. Materials and Methods: In this study, with help from dentists, 266 clinical samples were collected from dental patients who had periodontal infection. S. aureus isolated from samples was tested for their antibiotic susceptibility profiles. Silver nanoparticles and chlorhexidine were evaluated for their antibacterial activity against these S. aureus isolates. Results: S. aureus strains isolated from periodontal infection patients in this study were found to be multidrug resistant. AgNPs obtained using E. coli showed high inhibition of S. aureus growth when used in different concentrations (5, 10, 15, 20, 25mM). Chlorhexidine also exhibited antibacterial activity against S. aureus. Combination of AgNPs with penicillin and ciprofloxacin had an increasing significant effect on the sensitivity of S. aureus. Similarly, chlorhexidine in combination with penicillin and ciprofloxacin also showed an inhibitory effect on the growth of S. aureus. Conclusion: AgNPs and chlorhexidine combined with antibiotics used in treatment of S. aureus isolated from periodontal disease showed a good antibacterial effect which suggests its use as an antibacterial agent against periodontitis associated bacteria.

Characterization of two novel lytic bacteriophages having lysis potential against MDR avian pathogenic Escherichia coli strains of zoonotic potential

Avian pathogenic E. coli (APEC) is associated with local and systemic infections in poultry, ducks, turkeys, and many other avian species, leading to heavy economical losses. These APEC strains are presumed to possess zoonotic potential due to common virulence markers that can cause urinary tract infections in humans. The prophylactic use of antibiotics in the poultry sector has led to the rapid emergence of Multiple Drug Resistant (MDR) APEC strains that act as reservoirs and put human populations at risk. This calls for consideration of alternative strategies to decrease the bacterial load. Here, we report isolation, preliminary characterization, and genome analysis of two novel lytic phage species (Escherichia phage SKA49 and Escherichia phage SKA64) against MDR strain of APEC, QZJM25. Both phages were able to keep QZJM25 growth significantly less than the untreated bacterial control for approximately 18 h. The host range was tested against Escherichia coli strains of poultry and human UTI infections. SKA49 had a broader host range in contrast to SKA64. Both phages were stable at 37 °C only. Their genome analysis indicated their safety as no recombination, integration and host virulence genes were identified. Both these phages can be good candidates for control of APEC strains based on their lysis potential.

Efficacy and Safety of Two-Drug Regimens That Are Approved from 2018 to 2022 for the Treatment of Human Immunodeficiency Virus (HIV) Disease and Its Opportunistic Infections.

The human immunodeficiency virus (HIV) is a type of virus that targets the body's immune cells. HIV infection can be divided into three phases: acute HIV infection, chronic HIV infection, and acquired immunodeficiency syndrome (AIDS). HIV-infected people are immunosuppressed and at risk of developing opportunistic infections such as pneumonia, tuberculosis, candidiasis, toxoplasmosis, and Salmonella infection. The two types of HIV are known as HIV-1 and HIV-2. HIV-1 is the predominant and more common cause of AIDS worldwide, with an estimated 38 million people living with HIV-1 while an estimated 1 to 2 million people live with HIV-2. No effective cures are currently available for HIV infection. Current treatments emphasise the drug's safety and tolerability, as lifelong management is needed to manage HIV infection. The goal of this review is to study the efficacy and safety of newly approved drugs from 2018 to 2022 for the treatment of HIV by the United States Food and Drug Administration (US-FDA). The drugs included Cabotegravir and Rilpivirine, Fostemsavir, Doravirine, and Ibalizumab. From the review, switching to doravirine/lamivudine/tenofovir disoproxil fumarate (DOR/3TC/TDF) was shown to be noninferior to the continuation of the previous regimen, efavirenz/emtricitabine/tenofovir disoproxil fumarate (EFV/FTC/TDF) in virologically suppressed adults with HIV-1. However, DOR/3TC/TDF had shown a preferable safety profile with lower discontinuations due to adverse events (AEs), lower neuropsychiatric AEs, and a preferable lipid profile. Ibalizumab was also safe, well tolerated, and had been proven effective against multiple drug-resistant strains of viruses.

Novel Penicillin Derivatives Against Selected Multiple-Drug Resistant Bacterial Strains: Design, Synthesis, Structural Analysis, in silico and in Vitro Studies.

The rising numbers of multiple drug-resistant (MDR) pathogens and the consequent antibacterial therapy failure that resulted in severe medical conditions push to illustrate new molecules with extended activity against the resistant strains. In this manner, chemical derivatization of known antibiotics is proposed to save efforts in drug discovery, and penicillins serve as an ideal in this regard. Seven synthesized 6-aminopenicillanic acid-imine derivatives (2a-g) were structure elucidated using FT-IR, 1H NMR, 13C NMR, and MS spectroscopy. In silico molecular docking and ADMET studies were made. The analyzed compounds obeyed Lipinski's rule of five and showed promising in vitro bactericidal potential when assayed against E. coli, E. cloacae, P. aeruginosa, S. aureus, and A. baumannii. MDR strains using disc diffusion and microplate dilution techniques. The MIC values were 8 to 32 µg/mL with more potency than ampicillin, explained by better membrane penetration and more ligand-protein binding capacity. The 2g entity was active against E. coli. This study was designed to find new active penicillin derivatives against MDR pathogens. The products showed antibacterial activity against selected MDR species and good PHK, PHD properties, and low predicted toxicity, offering them as future candidates that require further preclinical assays.

A clash of quorum sensing vs quorum sensing inhibitors: an overview and risk of resistance.

Indiscriminate use of antibiotics to treat microbial pathogens has caused emergence of multiple drug resistant strains. Most infectious diseases are caused by microbes that are capable of intercommunication using signaling molecules, which is known as quorum sensing (QS). Such pathogens express their pathogenicity through various QS-regulated virulence factors. Interference of QS could lead to decisive results in controlling such pathogenicity. Hence, QS inhibition has become an attractive new approach for the development of novel drugs. Many quorum sensing inhibitors (QSIs) of diverse origins have been reported. It is imperative that more such anti-QS compounds be found and studied, as they have significant effect on microbial pathogenicity. This review attempts to give a brief account of QS mechanism, its inhibition and describes some compounds with anti-QS potential. Also discussed is the possibility of emergence of quorum sensing resistance.

Antibiotic resistance pattern of Methicillin-resistant Staphylococcus aureus in asymptomatic prisoners of Kathmandu valley

bjectives: The purpose of this study was to determine the prevalence of methicillin-resistant Staphylococcus aureus and its antimicrobial resistance among the prisoners within the prisons of Kathmandu valley. Methods: A total of 320 nasal samples were collected from the prisoners. S. aureus was confirmed by using standard microbiological techniques including culture and biochemical tests. MRSA was confirmed using cefoxitin disc and antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion method results were interpreted according to the guidelines of Clinical Laboratory Standard Institute (CLSI). Results: Out of 320 samples, 41 (12.82%) isolates were confirmed S. aureus and 8 (19.51%) of them were screened as MRSA positive. Highest percentage of MRSA was found in the samples collected from Nakhu prison 6 (75%) followed by Central prison 1 (12.5%) and Juvenile Correctional Home 1 (12.5%). Majority of the of MRSA isolates (62.5%) were also found to be multiple drug-resistant strains. All of the MRSA (100%) were sensitive towards linezolid and resistant towards ciprofloxacin. Conclusion: The presence of methicillin-resistant S. aureus among the prisoners indicates the emergence of drug resistance in a vulnerable population which may lead to hazardous disease breakouts in the prison and even in the community after their release. Regular monitoring and its minimization should be done in order to control its dissemination.

Determination of the antagonistic efficacy of silver nanoparticles against two major strains of Mycobacterium tuberculosis

Tuberculosis (TB) is considered one of the most prominent diseases across the globe. This present study aims to inspect the impact of silver nanoparticles (AgNP) against Mycobacterium tuberculosis, which is the causative vector of TB. The efficacy of the AgNP was conducted based on the minimum inhibitory concentration (MIC) of the AgNPs through microplate Alamar blue assay. The preparation of the AgNPs involved chemical synthesis. The state and the size of the AgNPs were determined and confirmed by using ultraviolet-visible (UV-Vis) absorption spectroscopy, X-ray diffraction (XRD) spectroscopy, and Transmission electron microscopy (TEM). This study evaluated two strains: Mycobacterium tuberculosis H37Rv and Mycobacterium bovis. In addition, another multiple drug-resistant Mycobacterium tuberculosis strain was also considered in this study, along with the clinically obtained isolates from Mycobacterium tuberculosis H37Rv and Mycobacterium tuberculosis bovis. The synthesized nanoparticles were found to be tetrahedral in shape with an average particle size of 45±3 nanometre (nm). The obtained results indicated that the proliferation of all the strains (two reference strains and one MDR strain) was resisted by the action of the synthesized AgNPs. The MIC of the MDR strain was noted within the range of 2-12 µg/ml, whereas the MIC for the Mycobacterium tuberculosis H37Rv and Mycobacterium bovis was noted in the range of 2-14 and 3-30 µg/ml, respectively. Accordingly, this study proposed a novel approach to combat tuberculosis, which is considered a global threat to humankind, indicating the present study's novelty.

Antimicrobial Resistance Surveillance of Tigecycline-Resistant Strains Isolated from Herbivores in Northwest China.

There is no doubt that antimicrobial resistance (AMR) is a global threat to public health and safety, regardless of whether it’s caused by people or natural transmission. This study aimed to investigate the genetic characteristics and variations of tigecycline-resistant Gram-negative isolates from herbivores in northwest China. In this study, a total of 300 samples were collected from various provinces in northwest China, and 11 strains (3.67%) of tigecycline-resistant bacteria were obtained. In addition, bacterial identification and antibiotic susceptibility testing against 14 antibiotics were performed. All isolates were multiple drug-resistant (MDR) and resistant to more than three kinds of antibiotics. Using an Illumina MiSeq platform, 11 tigecycline-resistant isolates were sequenced using whole genome sequencing (WGS). The assembled draft genomes were annotated, and then sequences were blasted against the AMR gene database and virulence factor database. Several resistance genes mediating drug resistance were detected by WGS, including fluoroquinolone resistance genes (gyrA_S83L, gyrA_D87N, S83L, parC_S80I, and gyrB_S463A), fosfomycin resistance genes (GlpT_E448K and UhpT_E350Q), beta-lactam resistance genes (FtsI_D350N and S357N), and the tigecycline resistance gene (tetR N/A). Furthermore, there were five kinds of chromosomally encoded genetic systems that confer MDR (MarR_Y137H, G103S, MarR_N/A, SoxR_N/A, SoxS_N/A, AcrR N/A, and MexZ_K127E). A comprehensive analysis of MDR strains derived from WGS was used to detect variable antimicrobial resistance genes and their precise mechanisms of resistance. In addition, we found a novel ST type of Escherichia coli (ST13667) and a newly discovered point mutation (K127E) in the MexZ gene of Pseudomonas aeruginosa. WGS plays a crucial role in AMR control, prevention strategies, as well as multifaceted intervention strategies.

Evaluation of clarithromycin and levofloxacin resistance of Helicobacter pylori strains isolated from patients at the Hospital for Tropical Diseases, Ho Chi Minh City

Clarithromycin (CLA) and levofloxacin (LFX) have been recommended as the most effective antibiotics for treating Helicobacter pylori infection. However, the increase in H. pylori’s resistance to antibiotics is an alarming and growing challenge. The study aimed to determine the antimicrobial resistance profiles of H. pylori strains isolated from patients at the Hospital for Tropical Diseases and to detect point mutations in 23S ribosomal RNA (23S rRNA) and gyraseA (gyrA) genes. Point mutations in 23S rRNA and gyrA were detected using Sanger sequencing. Antibiotic resistance was tested by the microdilution method. Out of the 45 isolates, 44 (97.8%) were found to be resistant to at least one antibiotic, 38 (84.4%) resistant to metronidazole (MTZ), and all were sensitive to amoxicillin (AMX) and tetracycline (TET). Sixty percent of the isolated strains were resistant to 3-6 antibiotics; among them, multiple drug resistance (MDR) strains presented twenty percent resistance to more than two classes of antibiotics. Eleven strains (24.4%) carried two mutations associated with CLA and LFX but only nine of them were dual resistant to CLA and LFX, and twenty-four (53.3%) carried either CLA or LFX mutation. The point mutations A2143G in the 23S rRNA and N87K (Asn87Lys) in the gyrA were detected in the CLA and LFX resistant strains, respectively. The prevalence of MDR, especially CLA, MTZ, and LFX resistance, in the H. pylori isolates suggests that the use of these antibiotics need to be more considerable and cautious.

Synergy of a virulent phage (φAB182) with antibiotics leading to successful elimination of biofilms formed by MDR Acinetobacter baumannii

Emergence of multiple drug resistant (MDR) strains of Acinetobacter baumannii and a withering drug discovery pipeline necessitates the search for effective alternatives to replace or synergize with currently used antibiotics. In this report, we have described the synergy assessment of a virulent Acinetobacter baumannii phage φAB182 with a wide range of antibiotics. Myophage φAB182 was isolated from sewage against MDR A. baumannii and exhibited maximum stability at 25 °C and pH 7. It also had a short latent period of 9min with a large burst size of 287. The phylogenetic analysis of its major capsid protein gene indicated an 84.15% similarity to the lyticA. baumannii phage Acj9. In the presence of antibiotics, phage φAB182 showed the highest synergy (p<0.0001) with colistin, followed by polymixin B, ceftazidime and cefotaxime and this synergistic effect was further validated by time kill kinetics. The combined action of phage φAB182 with colistin, polymixin B, ceftazidime and cefotaxime was also synergistic for the eradication of biofilms formed by A. baumannii as measured by MBECcombination/MBECantibiotic values (<0.25). We thus propose bacteriophage φAB182 as a potential antibacterial candidate in combination therapy. The findings from this study strongly support the use of phage antibiotic synergy for the successful treatment of biofilm forming MDR A. baumannii infections.

Chronic Kidney Disease-An Underestimated Risk Factor for Antimicrobial Resistance in Patients with Urinary Tract Infections.

(1) Background: Chronic kidney disease (CKD), as well as antimicrobial resistance (AMR) represent major global health problems, with important social and economic implications. It was reported that CKD is a risk factor for antimicrobial resistance, but evidence is scarce. In addition, CKD is recognized to be a risk factor for complicated urinary tract infections (UTIs). (2) Methods: We conducted an observational study on 564 adult in-hospital patients diagnosed with urinary tract infections. The aim of the study was to identify the risk factors for AMR, as well as multiple drug resistance (MDR) and the implicated resistance patterns. (3) Results: The mean age was 68.63 ± 17.2 years. The most frequently isolated uropathogens were Escherichia coli strains (68.3%) followed by Klebsiella species (spp. (11.2%). In 307 cases (54.4%)), the UTIs were determined by antibiotic-resistant bacteria (ARBs) and 169 cases (30%) were UTIs with MDR strains. Increased age (≥65) OR 2.156 (95% CI: 1.404–3.311), upper urinary tract obstruction OR 1.666 (1.083–2.564), indwelling urinary catheters OR 6.066 (3.919–9.390), chronic kidney disease OR 2.696 (1.832–3.969), chronic hemodialysis OR 4.955 (1.828–13.435) and active malignancies OR 1.962 (1.087–3.540) were independent risk factors for MDR UTIs. In a multivariate logistic regression model, only indwelling urinary catheters (OR 5.388, 95% CI: 3.294–8.814, p < 0.001), CKD (OR 1.779, 95% CI: 1.153–2.745, p = 0.009) and chronic hemodialysis (OR 4.068, 95% 1.413–11.715, p = 0.009) were risk factors for UTIs caused by MDR uropathogens. (4) Conclusions: CKD is an important risk factor for overall antimicrobial resistance, but also for multiple-drug resistance.