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Antibiotics
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Urinary Tract Infections and Antibiotic Intervention, 2nd Edition
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Urinary Tract Infections and Antibiotic Intervention, 2nd Edition

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: 20 August 2026 | Viewed by 5167

Special Issue Editor

Dr. Majid Mirzazadeh

E-Mail Website
Guest Editor
Department of Urology, Wake Forest School of Medicine, Winston-Salem, NC, USA
Interests: urinary microbiome; UTI; UTI in kidney stone patients; improvement of devices used in urinary tract; antibiotic stewardship in UTI
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The first edition of the Special Issue on “Urinary Tract Infections and Antibiotic Intervention”, published in 2023, is a successful collection of seven excellent papers and, as such, has encouraged us to open a second edition covering the same topic.

As a continuation of the first Special Issue, this second edition aims to increase our understanding of the urinary microbiome and its relationship with different disease conditions, clarifying the treatment indications for UTIs with different symptom levels, antibiotic overuse and its detrimental effects, superbugs, and antibiotic stewardship in UTIs.

The topics may include but are not limited to the following:

  • urinary tract infections (UTIs);
  • antibiotic use;
  • urinary microbiome;
  • urinary sepsis;
  • next-generation sequencing and urine culture.

Dr. Majid Mirzazadeh
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • UTI
  • antibiotic
  • microbiome
  • PCR
  • next-generation sequencing
  • urine culture
  • enhanced quantitative urine cultures
  • urinary sepsis

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Related Special Issue

Published Papers (3 papers)

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Research

17 pages, 694 KB  
Article
Prospective Evaluation of ESBL Risk Factors and Appropriateness of Empirical Therapy in Hospitalized Patients with Community-Onset Pyelonephritis
by Gülşah Gelişigüzel, Şerife Altun Demircan, Murat Aysin, Esra Kaya Kılıç, Serap Yağcı, Sami Kınıklı and Rukiye Berkem
Antibiotics 2026, 15(2), 229; https://doi.org/10.3390/antibiotics15020229 - 20 Feb 2026
Cited by 1 | Viewed by 814
Abstract
Background/Objectives: The rising prevalence of extended-spectrum beta-lactamase (ESBL)-producing pathogens has emerged as a significant challenge in the treatment of pyelonephritis. This study aims to determine the frequency of ESBL-producing agents in hospitalized patients with pyelonephritis, identify associated risk factors, and assess the [...] Read more.
Background/Objectives: The rising prevalence of extended-spectrum beta-lactamase (ESBL)-producing pathogens has emerged as a significant challenge in the treatment of pyelonephritis. This study aims to determine the frequency of ESBL-producing agents in hospitalized patients with pyelonephritis, identify associated risk factors, and assess the appropriateness of empirical antimicrobial therapy. Methods: This prospective study included patients hospitalized with pyelonephritis in the Infectious Diseases Clinic of Ankara Training and Research Hospital between 1 October 2022 and 29 February 2024. Demographic features, comorbidities, urinary system pathologies, history of urinary tract interventions, hospitalization more than one month prior, antibiotic use within the previous three months, and prior urinary tract infections were compared between patients infected with ESBL-producing and non-ESBL-producing organisms. Antimicrobial susceptibility profiles and the appropriateness of empirical treatments were evaluated. Statistical analyses were performed using SPSS version 25.0, with p < 0.05 considered statistically significant. Results: Escherichia coli (n = 142) and Klebsiella spp. (n = 43) were isolated in 180 of 204 patients. ESBL positivity was detected in 95 patients (52.7%). In the multivariate logistic regression analysis, male sex (p = 0.038) and hospitalization more than one month prior (p = 0.016) were identified as independent risk factors for ESBL positivity, while prior antibiotic use in the last three months showed a borderline association (p = 0.055) and did not reach statistical significance. ESBL production was not associated with prolonged hospitalization; however, bacteremia significantly increased length of stay (p < 0.001). Antimicrobial susceptibility rates were markedly lower in the ESBL-positive group. The appropriateness of empirical therapy was also significantly reduced, with piperacillin–tazobactam being the most frequently inappropriate agent due to high resistance rates and unnecessary broad-spectrum use. Conclusions: ESBL-producing pathogens were highly prevalent among hospitalized patients with pyelonephritis. The low appropriateness of empirical therapy in ESBL-positive cases underscores the need for careful evaluation of ESBL risk factors prior to treatment initiation, as ESBL rates may approach 50%. Full article
(This article belongs to the Special Issue Urinary Tract Infections and Antibiotic Intervention, 2nd Edition)
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28 pages, 1189 KB  
Article
Etiopathogenesis and Antibacterial Therapy Approach in Patients with Acute Obstructive Pyelonephritis—A Retrospective Study
by Valentin Mitroi, Bogdan Mastalier, Dumitru Dragos Chitca, Andi Fieraru, Iulia Malina Mitroi, Violeta Popovici, Emma Adriana Ozon and Oana Săndulescu
Antibiotics 2026, 15(2), 164; https://doi.org/10.3390/antibiotics15020164 - 4 Feb 2026
Cited by 1 | Viewed by 1909
Abstract
Objectives: Acute obstructive pyelonephritis (AOP) is a urological emergency that combines bacterial infection with upper urinary tract obstruction. This retrospective study focuses on the microbial etiology and causes of obstruction, clinical manifestations, antibacterial therapy, drainage type, and outcomes in patients diagnosed with AOP [...] Read more.
Objectives: Acute obstructive pyelonephritis (AOP) is a urological emergency that combines bacterial infection with upper urinary tract obstruction. This retrospective study focuses on the microbial etiology and causes of obstruction, clinical manifestations, antibacterial therapy, drainage type, and outcomes in patients diagnosed with AOP at a tertiary urology center between 1 January 2020 and 30 December 2024. Methods: One hundred patients with a mean age of 61.30 years were included in this retrospective study, which examines demographic data, comorbidities, clinical features, pathogens involved, antimicrobial regimens, and hospital outcomes. Results: Urolithiasis was the most frequent cause of obstruction (62%), followed by ureteral stenosis (14%) and tumors (11%). AOPs were mainly produced by Escherichia coli (58%), followed by Klebsiella spp. (21%); 18% of all identified bacteria were ESBL-producing Gram-negative bacilli, and 29% were MDR bacteria. The most used IV antibiotics were fluoroquinolones (52%), followed by cephalosporins (19%) and carbapenems (18%). Carbapenems were administered to all patients with AOP caused by ESBL-producing pathogens and to 62% of those with MDR bacteria. The duration of antibiotic therapy was individualized based on clinical response. Switch to oral administration was made after 4.3 ± 1.5 days, and the antibiotic treatment lasted 10.8 ± 3.2 days. Conclusions: The results of the present study support integrating evidence-based guidelines with regional patterns of bacterial susceptibility to optimize therapeutic approaches and reduce severe outcomes in patients with AOP, most of whom have multiple comorbidities. Full article
(This article belongs to the Special Issue Urinary Tract Infections and Antibiotic Intervention, 2nd Edition)
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10 pages, 371 KB  
Article
Clinical Impact of Treating Versus Not Treating Asymptomatic Bacteriuria/Candiduria in the First Two Months After Kidney Transplantation
by Biagio Pinchera, Rosa Carrano, Isabella Di Filippo, Vincenzo Fotticchia, Mariangela Petrone, Francesco Antimo Alfè, Gianmarco Borriello, Amerigo Piccione, Fabrizio Salemi and Ivan Gentile
Antibiotics 2025, 14(11), 1155; https://doi.org/10.3390/antibiotics14111155 - 14 Nov 2025
Viewed by 1719
Abstract
Background/Objectives: The management of asymptomatic bacteriuria (ASB) and candiduria (ASC) in kidney transplant recipients during the early post-transplant period is controversial. This study aimed to evaluate whether treating, versus not treating, ASB and ASC episodes in the first two months after kidney transplantation [...] Read more.
Background/Objectives: The management of asymptomatic bacteriuria (ASB) and candiduria (ASC) in kidney transplant recipients during the early post-transplant period is controversial. This study aimed to evaluate whether treating, versus not treating, ASB and ASC episodes in the first two months after kidney transplantation influences clinical outcomes and the emergence of multidrug-resistant (MDR) infections. Methods: We conducted a single-center retrospective cohort study enrolling patients with ASB or ASC occurring in the first two months after kidney transplantation between January 2019 and July 2024. Patients were classified into treated and untreated groups. The primary endpoint was 30-day mortality. Secondary endpoints included mortality at 90, 180 and 360 days; incidence of sepsis or septic shock; bacteremia/candidemia, hospitalization, graft loss; decline in renal function, urinary tract infections (UTIs), recurrent UTI and rate of MDR colonization/infection. Results: We enrolled 59 kidney transplant recipients and observed 147 episodes of ASB/ASC. Of the 147 episodes, 95 were untreated and 52 were treated. No significant differences were observed between treated and untreated patients in 30-day (2.1% vs. 3.8%) or 90-day mortality (2.1% vs. 1.9%), nor in any of the secondary clinical outcomes. However, patients who received treatment tended to have a higher rate of MDR colonization/infection (63% vs. 46%). MDR pathogen isolation was significantly associated with increased risks of septic shock (OR 4.639, p = 0.04), bacteremia/candidemia (OR 3.734, p = 0.01), hospitalization (OR 2.183, p = 0.03) and renal function deterioration (OR 3.93, p = 0.03). Conclusions: Antimicrobial treatment of ASB and ASC in the early post-transplant period would seem not to confer clinical benefit and may be associated with the risk of MDR colonization/infection. Full article
(This article belongs to the Special Issue Urinary Tract Infections and Antibiotic Intervention, 2nd Edition)
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