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. 2019 Sep 9;8(3):143.
doi: 10.3390/antibiotics8030143.

Resistance Levels and Epidemiology of Non-Fermenting Gram-Negative Bacteria in Urinary Tract Infections of Inpatients and Outpatients (RENFUTI): A 10-Year Epidemiological Snapshot

Márió Gajdács  1 , Katalin Burián  2   3 , Gabriella Terhes  4
Affiliations

Resistance Levels and Epidemiology of Non-Fermenting Gram-Negative Bacteria in Urinary Tract Infections of Inpatients and Outpatients (RENFUTI): A 10-Year Epidemiological Snapshot

Márió Gajdács et al. Antibiotics (Basel). .

Abstract

Background: 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. Methods: 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. Results: NFGNB represented 3.46% ± 0.93% for the outpatients, while 6.43% ± 0.81% of all positive urine samples for the inpatients (p < 0.001). In both groups, Pseudomonas spp. (78.7% compared to 85.1%) and Acinetobacter spp. (19.6% compared to 10.9%), were the most prevalent. The Acinetobacter resistance levels were significantly higher in inpatients isolates (p values ranging between 0.046 and <0.001), while the differences in the resistance levels of Pseudomonas was not as pronounced. The β-lactam-resistance levels were between 15-25% and 12-28% for the Acinetobacter and Pseudomonas spp., respectively. 4.71% of Acinetobacter and 1.67% of Pseudomonas were extensively drug resistant (XDR); no colistin-resistant isolates were recovered. Conclusions: Increasing resistance levels of the Acinetobacter spp. from 2013 onward, but not in the case of the Pseudomonas spp. Although rare, the drug resistant NFGNB in UTIs present a concerning therapeutic challenge to clinicians with few therapeutic options left.

Keywords: Acinetobacter; Pseudomonas; Stenotrophomonas; UTI; antibiotic; epidemiology; non-fermenting; resistance; urinary tract infection.

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Conflict of interest statement

The authors declare no conflict of interest, monetary or otherwise.

Figures

Figure 1
Figure 1
Age distribution of the affected patients in the outpatient and inpatient group.
Figure 2
Figure 2
Frequency and species distribution of non-fermenting Gram-negative bacterial (NFGNB) isolates in the outpatient samples (2008—2017).
Figure 3
Figure 3
Frequency and species distribution of non-fermenting Gram-negative bacterial (NFGNB) isolates in the inpatient samples (2008—2017).
See this image and copyright information in PMC

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