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Article

Comparative Epidemiology and Resistance Trends of Proteae in Urinary Tract Infections of Inpatients and Outpatients: A 10-Year Retrospective Study

by 1,2,* and 3
1
Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, 6720 Szeged, Eötvös utca 6., Hungary
2
Institute of Clinical Microbiology, Faculty of Medicine, University of Szeged, 6725 Szeged, Semmelweis utca 6., Hungary
3
Department of Public Health, Faculty of Medicine, University of Szeged, 6720 Szeged, Dóm tér 10., Hungary
*
Author to whom correspondence should be addressed.
Received: 15 May 2019 / Revised: 8 July 2019 / Accepted: 9 July 2019 / Published: 11 July 2019
(This article belongs to the Special Issue Antimicrobial Resistance in Gram-negative Bacteria)
Compared with infections caused by other bacterial pathogens, urinary tract infections (UTIs) caused by Proteae are often more severe and associated with a higher rate of recurrence, sequelae, and pyelonephritis. The aim of this retrospective study was to assess and compare the prevalence of UTIs caused by different species of the Proteae tribe (namely Proteus, Morganella and Providencia species) and the antibiotic resistance levels isolated from inpatients and outpatients in a primary- and tertiary-care teaching hospital in the Southern Great Plain of Hungary, during a 10-year study period. To evaluate the resistance trends of isolated strains, amoxicillin/clavulanic acid, ceftriaxone, meropenem, ertapenem, gentamicin, ciprofloxacin, and fosfomycin were chosen as indicator antibiotics, based on local antibiotic utilization data. Members of Proteae were more frequently isolated in the case of inpatients (7.20 ± 1.74% vs. 5.00 ± 0.88%; p = 0.0031), P. mirabilis was the most frequently isolated member of the group. The ratio of resistant strains to sulfamethoxazole/trimethoprim, ciprofloxacin, ceftriaxone, and fosfomycin was significantly higher in the inpatient group. In the case of amoxicillin/clavulanic acid, ceftriaxone, ciprofloxacin, and sulfamethoxazole/trimethoprim, the ratio of resistant isolates was markedly higher between 2013–2017 (p < 0.01). Resistance developments of Proteae, coupled with their intrinsic non-susceptibility to several antibiotics (tetracyclines, colistin, nitrofurantoin) severely limits the number of therapeutic alternatives, especially for outpatients. View Full-Text
Keywords: urinary tract infection; UTI; antibiotic; resistance; indicator; epidemiology; fosfomycin; Morganella; Proteus; Providencia urinary tract infection; UTI; antibiotic; resistance; indicator; epidemiology; fosfomycin; Morganella; Proteus; Providencia
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MDPI and ACS Style

Gajdács, M.; Urbán, E. Comparative Epidemiology and Resistance Trends of Proteae in Urinary Tract Infections of Inpatients and Outpatients: A 10-Year Retrospective Study. Antibiotics 2019, 8, 91. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics8030091

AMA Style

Gajdács M, Urbán E. Comparative Epidemiology and Resistance Trends of Proteae in Urinary Tract Infections of Inpatients and Outpatients: A 10-Year Retrospective Study. Antibiotics. 2019; 8(3):91. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics8030091

Chicago/Turabian Style

Gajdács, Márió, and Edit Urbán. 2019. "Comparative Epidemiology and Resistance Trends of Proteae in Urinary Tract Infections of Inpatients and Outpatients: A 10-Year Retrospective Study" Antibiotics 8, no. 3: 91. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics8030091

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