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Increasingly resistant UTI-causing pathogens spark concerns

A new study highlights increasing antibiotic resistance in gram-negative rods (GNRs) causing urinary tract infection (UTI) in adults, particularly against beta-lactams, trimethoprim and quinolones.

UTIs in adults continue to be the leading cause of hospital presentation and admissions globally. GNRs are the most common pathogens responsible for UTIs. The National Institute for Health and Care Excellence guidelines recommend nitrofurantoin and trimethoprim as first-line antibiotics for lower UTI and ciprofloxacin or co-amoxiclav as first-line oral agents for upper UTI, including pyelonephritis.

Researchers conducted a cross-sectional study involving 156 patients (mean age, 78 years; 59.6% females) with UTI admitted to Russells Hall Hospital Dudley, UK.

Majority of the samples (67.3%) were midstream urine, 23.1 per cent were catheter urine and 9.6 per cent were others, including nephrostomy bags or unspecified. Escherichia coli was seen in 52.6 per cent of samples, Proteus in 10.9 per cent, Klebsiella in 9.0 per cent, Pseudomonas in 4.5 per cent and other species in 13.5 per cent of samples.

Antibiotic resistance in GNRs was highest against amoxcillin (61.7%), followed by cephalexin (44.4%), co-amoxiclav (36.2%), trimethoprim (36.2%), ciprofloxacin (25.6%), nitrofurantoin (13.5%), gentamicin (12.8%), fosfomycin (10.7%) and piperacillin-tazobactam (7.1%). None of the uropathogens was found to be resistant to meropenem.

Writing in the Cureus Journal of Medical Science, the authors call for immediate measures to control antibiotics prescriptions and limiting antibiotic use only when required.


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