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Antibiotics
Special Issues
The Interplay between Urinary Tract Infections and Antimicrobial Resistance
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The Interplay between Urinary Tract Infections and Antimicrobial Resistance

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotic Therapy in Infectious Diseases".

Deadline for manuscript submissions: closed (15 August 2023) | Viewed by 8497

Special Issue Editor

Dr. Álex Smithson

E-Mail Website
Guest Editor
Unidad de Medicina Interna, Fundació Hospital de l’Esperit Sant, 08923 Santa Coloma de Gramenet, Spain
Interests: prevention and treatment of urinary tract infections; antimicrobial resistance; antimicrobial stewardship; healthcare-associated infections

Special Issue Information

Dear Colleagues,

Urinary tract infections (UTI) are one of the most common infections in all healthcare settings. The incidence of UTI increases with age being the main source of community-acquired bacteremia and an important cause of mortality. In addition, UTI are frequently over-diagnosed, particularly in older patients and in those with indwelling urinary catheters, due to the high prevalence of asymptomatic bacteriuria. This leads to high antimicrobial consumption, many times inadequately indicated, which is a driver of antimicrobial selective pressure and antimicrobial resistance. In fact, UTI are the main source of infections caused by multi-resistant microorganisms, some of which are particularly challenging to treat, such as prostate infections. Therefore, UTI should become one of the main focus of the antimicrobial stewardship programs. In addition, new non-antimicrobial therapeutic strategies should be evaluated in order to avoid the use of antibiotics, including the use of sublingual vaccination which have showed promising results in patients with recurrent UTI. 

In this Special Issue of Antibiotics, authors are invited to submit articles covering any topic related to the interplay between UTI and antimicrobial resistance, including some of the following topics:

  • Diagnosis and treatment UTI with special focus in older adults and the management of asymptomatic bacteriuria;
  • Antibiotic resistance in uropathogens;
  • Management of chronic prostatitis due to multi-resistant microorganisms;
  • Antimicrobial stewardship;
  • Role of non-antimicrobial therapies for the management of UTI including sublingual vaccination.

Dr. Álex Smithson
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • urinary tract infections
  • uropathogens
  • prostate infections
  • antimicrobial stewardship
  • antimicrobial resistance
  • novel therapeutic strategies

Published Papers (3 papers)

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Research

10 pages, 1613 KiB  
Article
Antimicrobial Resistance Patterns of Enterobacter cloacae and Klebsiella aerogenes Strains Isolated from Clinical Specimens: A Twenty-Year Surveillance Study
by Jari Intra, Davide Carcione, Roberta Maria Sala, Claudia Siracusa, Paolo Brambilla and Valerio Leoni
Antibiotics 2023, 12(4), 775; https://doi.org/10.3390/antibiotics12040775 - 18 Apr 2023
Cited by 6 | Viewed by 2977
Abstract
We retrospectively analyzed the antimicrobial data of Enterobacter spp. strains isolated from hospitalized subjects and outpatients over 20 years (2000–2019). A total of 2277 non-duplicate Enterobacter spp. isolates, 1037 from outpatients (45%) and 1240 from hospitalized subjects (55%), were retrieved. Most of samples [...] Read more.
We retrospectively analyzed the antimicrobial data of Enterobacter spp. strains isolated from hospitalized subjects and outpatients over 20 years (2000–2019). A total of 2277 non-duplicate Enterobacter spp. isolates, 1037 from outpatients (45%) and 1240 from hospitalized subjects (55%), were retrieved. Most of samples are infections of the urinary tract. Considering Enterobacter aerogenes, now classified as Klebsiella aerogenes, and Enterobacter cloacae, representing more than 90% of all isolates, except for aminoglycosides and fluroquinolones, which showed significant antibiotic decreasing trends (p < 0.01), none of the other antimicrobial agents tested showed significant changes in both groups (p > 0.05). Conversely, there was a significant increasing resistance trend for fosfomycin (p < 0.01), among both community and hospital-related subjects, most probably owing to uncontrolled and improper usage. Surveillance studies on antibiotic resistance at the local and regional level are required to detect new resistance mechanisms, reduce inappropriate antimicrobial consumption, and increase the focus on antimicrobial stewardship. Full article
(This article belongs to the Special Issue The Interplay between Urinary Tract Infections and Antimicrobial Resistance)
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15 pages, 3787 KiB  
Article
The Genotypic and Phenotypic Characteristics Contributing to Flomoxef Sensitivity in Clinical Isolates of ESBL-Producing E. coli Strains from Urinary Tract Infections
by Kazuma Sakaeda, Takuya Sadahira, Yuki Maruyama, Takehiro Iwata, Masami Watanabe, Koichiro Wada and Motoo Araki
Antibiotics 2023, 12(3), 522; https://doi.org/10.3390/antibiotics12030522 - 06 Mar 2023
Viewed by 1582
Abstract
We carried out a molecular biological analysis of extended-spectrum β-lactamase (ESBL)-producing E. coli strains and their sensitivity to flomoxef (FMOX). Sequence type (ST) analysis by multilocus sequence typing (MLST) and classification of ESBL genotypes by multiplex PCR were performed on ESBL-producing E. coli [...] Read more.
We carried out a molecular biological analysis of extended-spectrum β-lactamase (ESBL)-producing E. coli strains and their sensitivity to flomoxef (FMOX). Sequence type (ST) analysis by multilocus sequence typing (MLST) and classification of ESBL genotypes by multiplex PCR were performed on ESBL-producing E. coli strains isolated from urine samples collected from patients treated at our institution between 2008 and 2018. These sequences were compared with results for antimicrobial drug susceptibility determined using a micro-liquid dilution method. We also analyzed cases treated with FMOX at our institution to examine its clinical efficacy. Of the 911 E. coli strains identified, 158 (17.3%) were ESBL-producing. Of these, 67.7% (107/158) were strain ST-131 in ST analysis. Nearly all (154/158; 97.5%) were CTX-M genotypes, with M-14 and M-27 predominating. The isolated strains were sensitive to FMOX in drug susceptibility tests. Among the patient samples, 33 cases received FMOX, and of these, 5 had ESBL-producing E. coli. Among these five cases, three received FMOX for surgical prophylaxis as urinary carriers of ESBL-producing E. coli, and postoperative infections were prevented in all three patients. The other two patients received FMOX treatment for urinary tract infections. FMOX treatment was successful for one, and the other was switched to carbapenem. Our results suggest that FMOX has efficacy for perioperative prophylactic administration in urologic surgery involving carriers of ESBL-producing bacteria and for therapeutic administration for urinary tract infections. Use of FMOX avoids over-reliance on carbapenems or β-lactamase inhibitors and thus is an effective antimicrobial countermeasure. Full article
(This article belongs to the Special Issue The Interplay between Urinary Tract Infections and Antimicrobial Resistance)
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9 pages, 680 KiB  
Article
Fluoroquinolones Are Useful as Directed Treatment for Complicated UTI in a Setting with a High Prevalence of Quinolone-Resistant Microorganisms
by Arturo Artero, Ian López-Cruz, Laura Piles, Juan Alberola, José María Eiros, Sofia Salavert and Manuel Madrazo
Antibiotics 2023, 12(1), 183; https://doi.org/10.3390/antibiotics12010183 - 16 Jan 2023
Viewed by 3323
Abstract
Fluoroquinolones (FQs) have been widely used for treating urinary tract infections (UTIs); however, the increasing emergence of resistant strains has compromised their use. We aimed to know the usefulness of FQs for the treatment of community-acquired UTI in a setting with a high [...] Read more.
Fluoroquinolones (FQs) have been widely used for treating urinary tract infections (UTIs); however, the increasing emergence of resistant strains has compromised their use. We aimed to know the usefulness of FQs for the treatment of community-acquired UTI in a setting with a high prevalence of fluoroquinolone-resistant microorganisms. A prospective observational study of patients diagnosed with community-acquired UTI was conducted, in which their outcomes according to whether they had FQs or not in their empirical and directed treatments were compared. A multivariate analysis was performed to identify risk factors for UTIs due to ciprofloxacin-resistant microorganisms. A total of 419 patients were included; 162 (38.7%) patients were treated with FQs, as empirical treatment in 27 (6.4%), and as directed treatment in 135 (32.2%). In-hospital mortality (2.2% vs. 6.6%, p 0.044) and 30-day mortality (4.4 vs. 11%, p 0.028) were both lower in the group of patients directly treated with FQ, while there were no differences when FQs were used as empirical treatment. A total of 37.2% of the cases were resistant to ciprofloxacin, which was associated with healthcare-associated UTI (OR 2.7, 95% CI 2–3.7) and prior exposure to FQs (OR 2.7, 95 % CI 1.9–3.7). In conclusion, our findings show that in a setting with a high prevalence of community-acquired UTI caused by quinolone-resistant microorganisms, FQs as directed treatment for community-acquired UTI were associated with better outcomes than other antibiotics, but their use as empirical treatment is not indicated, even in those cases without risk factors for quinolones resistance. Full article
(This article belongs to the Special Issue The Interplay between Urinary Tract Infections and Antimicrobial Resistance)
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