Comparative Epidemiology and Resistance Trends of Common Urinary Pathogens in a Tertiary-Care Hospital: A 10-Year Surveillance Study

• Published in: Medicina (Kaunas, Lithuania) Lithuania), 2019-07, Vol.55 (7), p.356
• Main Authors: Gajdács, Márió, Ábrók, Marianna, Lázár, Andrea, Burián, Katalin
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - therapeutic use; antibiotic; beta-Lactamases - therapeutic use; Child; Child, Preschool; Drug Resistance, Bacterial; epidemiology; ESBL; Escherichia coli; Escherichia coli - drug effects; Escherichia coli - pathogenicity; Female; fosfomycin; Humans; Hungary - epidemiology; indicator; Infant; infectious disease; Klebsiella; Klebsiella - drug effects; Klebsiella - pathogenicity; Male; Middle Aged; Population Surveillance - methods; Prevalence; resistance; Retrospective Studies; Tertiary Care Centers - organization & administration; Tertiary Care Centers - statistics & numerical data; urinary tract infection; Urinary Tract Infections - epidemiology; Urinary Tract Infections - microbiology
• ISSN: 1648-9144; 1010-660X; 1648-9144; 1010-660X
• DOI: 10.3390/medicina55070356

Urinary tract infections (UTIs) are common in human medicine, affecting large patient populations worldwide. The principal cause of UTIs is uropathogenic (UPEC) and , both in community and nosocomial settings. The assessment of local data on prevalence and resistance is essential to evaluate trends over time and to reflect on the national situation, compared to international data, using the methods of analytical epidemiology. The aim of this study was to assess resistance trends and epidemiology of UTIs caused by and species in inpatients and outpatients at a tertiary-care hospital in Hungary, using microbiological data. To evaluate resistance trends, several antibiotics were chosen as indicator drugs, based on local utilization data. was the most prevalent isolate, representing 56.75 ± 4.86% for outpatients and 42.29 ± 2.94% for inpatients. For , the ratio of resistant strains for several antibiotics was significantly higher in the inpatient group, while in , similar trends were only observed for gentamicin. Extended-spectrum β-lactamase (ESBL)-producing isolates were detected in 4.33-9.15% and 23.22-34.22% from outpatient, 8.85-38.97% and 10.89-36.06% from inpatient samples for and , respectively. Resistance developments in common UTI pathogens (especially to fosfomycin, sulfamethoxazole-trimethoprim, fluoroquinolones, and 3rd generation cephalosporins), seriously curb therapeutic options, especially in outpatient settings.