Emerging patterns of resistance in a cohort of Greek patients with recurrent UTIs: a pilot study

Characteristics of urinary tract infections in older patients in a tertiary hospital in Greece

“…Greece is a country associated with alarming rates of antimicrobial resistance, thus, better understanding of the local trends of resistance are necessary to treat patients with drug-resistant UTIs appropriately. 10 Older patients are thought to be at higher risk of developing UTIs due to several reasons, which are associated with increasing age, such as immobility, changes in the urinary tract system, more frequent use of urinary catheters, antimicrobials and frequent hospitalizations, as well as due to age-related defects in host defense mechanisms. 5 Thus, it is of no surprise that in our study the population consisted of very old patients (75% were at least 80 years old), even though older patients are more likely to be hospitalized for a UTI, due to comorbidities and frailty.…”

“…15 In our population, most patients were female, which is in line with the literature. 10,16 One of three patients had received antimicrobials the last 3 months, while previous UTI within the last year was present in one of every five patients. These are both in line with other studies showing comparable previous antimicrobial use and comparable rates of recent UTI in another cohort of hospitalized patients with complicated UTI.…”

“…In terms of microbiology, E. coli was the commonest pathogen followed by K. pneumoniae, P. mirabilis and E. faecalis adding up to 75% of all the isolated pathogens, which is in line with the literature. 6,7,21 Regarding antimicrobial resistance, almost 17% of the patients had an infection from a resistant pathogen (ESBL, MDR, XDR or VRE), which is higher than in other countries 21 and adds up to the worrisome results of antimicrobial resistance in Greece 10,[22][23][24][25] ; however, the increased percentage in our study could be associated with the fact that our study population was older than in other studies, 21,22 as older patients are thought to harbor resistant microorganisms more often, due to exposure to the healthcare system and nursing-care facilities and more frequent use of antimicrobials. 26 Overall mortality in our study was 18%, which was higher than in other studies where mortality was <10%.…”

“…[6][7][8] Antimicrobial resistance is an emerging problem in the management of UTIs, with extended-spectrum-β-lactamase (ESBL) producing Gram-negative bacteria and multidrug-resistant Pseudomonas aeruginosa being increasingly common both in hospital-acquired UTIs and in the community. 9,10 The purpose of this study was to investigate the epidemiology and outcomes of UTIs in older patients admitted to a tertiary hospital in a country with particular antimicrobial resistance patterns, compare the effects of antimicrobial resistance on patient outcomes and to identify independent factors associated with mortality, or developing an infection from a multidrug-resistant microorganism.…”

Rapid identification of bacterial mixtures in urine using MALDI-TOF MS-based algorithm profiling coupled with magnetic enrichment

“…[1][2][3] UTIs are mainly caused by mono-bacteria like Escherichia coli, the most prevalent causative agent, and other pathogenic bacteria, which include Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, Staphylococcus aureus, and Candida spp. [4][5][6][7] Occasionally, more than one species is observed in UTIs. Culture-based biochemical methods are still the current routine methods for the diagnosis of UTIs in clinical microbiology laboratories.…”