Increasing relevance of Gram-positive cocci in urinary tract infections: a 10-year analysis of their prevalence and resistance trends

• Published in: Scientific reports 2020-10, Vol.10 (1), p.17658-17658, Article 17658
• Main Authors: Gajdács, Márió, Ábrók, Marianna, Lázár, Andrea, Burián, Katalin
• Format: Article
• Language: English
• Subjects: 631/326/107; 631/326/1320; 631/326/22; 692/308/174; 692/4025/2021; 692/4025/2768; Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Anti-Bacterial Agents - therapeutic use; Child; Child, Preschool; Drug Resistance, Bacterial; Enterococcus - drug effects; Female; Gram-Positive Bacterial Infections - drug therapy; Gram-Positive Bacterial Infections - epidemiology; Gram-Positive Bacterial Infections - microbiology; Gram-Positive Cocci - drug effects; Humanities and Social Sciences; Humans; Infant; Male; Microbial Sensitivity Tests; Middle Aged; multidisciplinary; Prevalence; Science; Science (multidisciplinary); Sex Factors; Urinary Tract Infections - drug therapy; Urinary Tract Infections - epidemiology; Urinary Tract Infections - microbiology; Young Adult
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-020-74834-y

Urinary tract infections (UTIs) are the third most common types of infection in human medicine worldwide. There is increasing appreciation for the pathogenic role of Gram-positive cocci (GPC) in UTIs, as they have a plethora of virulence factors, maintaining their pathogenicity and high affinity for the epithelial cells of the urinary tract . The study was carried out using microbiological data collected corresponding to the period between 2008 and 2017. Antimicrobial susceptibility testing was performed using the disk diffusion method and E-tests. The age range of patients affected from the outpatient and inpatient groups differed significantly (43 [range 0.7–99] vs. 68 [range 0.4–99] years; p  = 0.008). 3962 GPCs were obtained from inpatient and 4358 from outpatient samples, corresponding to 20.5 ± 2.8% (range 17.5–26.8%) and 20.6 ± 2.6% (range 17.8–26.0%) of all positive urine samples ( p  > 0.05); in both groups, Enterococcus spp. were the most prevalent (outpatients: 79.6%; inpatients: 88.5%). High-level aminoglycoside resistance in enterococci was noted in 31.0–46.6% of cases. A pronounced increase in the number of MRSA was seen in the second half of the study period (0.6–1.9% vs. 9.8–11.6%; p  = 0.038). The ratio of VRE isolates was 0.16%, no VISA/VRSA isolates were detected.