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Resistance Levels and Epidemiology of Non-Fermenting Gram-Negative Bacteria in Urinary Tract Infections of Inpatients and Outpatients (RENFUTI): A 10-Year Epidemiological Snapshot
oleh: Márió Gajdács, Katalin Burián, Gabriella Terhes
Format: | Article |
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Diterbitkan: | MDPI AG 2019-09-01 |
Deskripsi
<i>Background:</i> Urinary tract infections (UTIs) are one of the most common infections in the human medicine, both among outpatients and inpatients. There is an increasing appreciation for the pathogenic role of non-fermenting Gram-negative bacteria (NFGNBs) in UTIs, particularly in the presence of underlying illnesses. <i>Methods:</i> The study was carried out using data regarding a 10-year period (2008–2017). The antimicrobial susceptibility testing was performed using the disk diffusion method, E-tests, and broth microdilution. <i>Results:</i> NFGNB represented 3.46% ± 0.93% for the outpatients, while 6.43% ± 0.81% of all positive urine samples for the inpatients (<i>p</i> < 0.001). In both groups, <i>Pseudomonas</i> spp. (78.7% compared to 85.1%) and <i>Acinetobacter</i> spp. (19.6% compared to 10.9%), were the most prevalent. The <i>Acinetobacter</i> resistance levels were significantly higher in inpatients isolates (<i>p</i> values ranging between 0.046 and <0.001), while the differences in the resistance levels of <i>Pseudomonas</i> was not as pronounced. The <i>β</i>-lactam-resistance levels were between 15–25% and 12–28% for the <i>Acinetobacter</i> and <i>Pseudomonas</i> spp., respectively. 4.71% of <i>Acinetobacter</i> and 1.67% of <i>Pseudomonas</i> were extensively drug resistant (XDR); no colistin-resistant isolates were recovered. <i>Conclusions:</i> Increasing resistance levels of the <i>Acinetobacter</i> spp. from 2013 onward, but not in the case of the <i>Pseudomonas</i> spp. Although rare, the drug resistant NFGNB in UTIs present a concerning therapeutic challenge to clinicians with few therapeutic options left.