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Antibiotics 2014, 3(3), 341-352;

Uncomplicated Urinary Tract Infections and Antibiotic Resistance—Epidemiological and Mechanistic Aspects

Hoi 15, 24882 Schaalby, Germany
Pharmaceutical Biology and Microbiology, Institute of Biochemistry and Molecular Biology, University of Hamburg, Bundesstrasse 45, 20146 Hamburg, Germany
Author to whom correspondence should be addressed.
Received: 23 April 2014 / Revised: 11 July 2014 / Accepted: 14 July 2014 / Published: 22 July 2014
(This article belongs to the Special Issue Antibiotics and Urinary Tract Infections)
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Uncomplicated urinary tract infections are typically monobacterial and are predominantly caused by Escherichia coli. Although several effective treatment options are available, the rates of antibiotic resistance in urinary isolates of E. coli have increased during the last decade. Knowledge of the actual local rates of antibiotic resistant pathogens as well as the underlying mechanisms are important factors in addition to the geographical location and the health state of the patient for choosing the most effective antibiotic treatment. Recommended treatment options include trimethoprim alone or in combination with sulfamethoxazol, fluoroquinolones, β-lactams, fosfomycin-trometamol, and nitrofurantoin. Three basic mechanisms of resistance to all antibiotics are known, i.e., target alteration, reduced drug concentration and inactivation of the drug. These mechanisms—alone or in combination—contribute to resistance against the different antibiotic classes. With increasing prevalence, combinations of resistance mechanisms leading to multiple drug resistant (mdr) pathogens are being detected and have been associated with reduced fitness under in vitro situations. However, mdr clones among clinical isolates such as E. coli sequence type 131 (ST131) have successfully adapted in fitness and growth rate and are rapidly spreading as a worldwide predominating clone of extraintestinal pathogenic E. coli. View Full-Text
Keywords: uUTI; antibiotic resistance; fluoroquinolone; β-lactam uUTI; antibiotic resistance; fluoroquinolone; β-lactam
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).

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Wiedemann, B.; Heisig, A.; Heisig, P. Uncomplicated Urinary Tract Infections and Antibiotic Resistance—Epidemiological and Mechanistic Aspects. Antibiotics 2014, 3, 341-352.

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