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Antibiotics
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Uropathogens—Antibiotic Resistance and Alternative Therapies, 2nd Edition
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Uropathogens—Antibiotic Resistance and Alternative Therapies, 2nd Edition

A special issue of Antibiotics (ISSN 2079-6382).

Deadline for manuscript submissions: closed (30 June 2024) | Viewed by 17644

Special Issue Editors

Dr. Barbara Kot

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Guest Editor
Institute of Biological Sciences, Faculty of Exact and Natural Sciences, Siedlce University of Natural Sciences and Humanities, B. Prusa 14, 08-110 Siedlce, Poland
Interests: antimicrobial resistant bacteria; resistance genes, bacterial adhesion; biofilms; uropathogenic E. coli; Staphylococcus aureus; MRSA; natural bioactive compounds
Special Issues, Collections and Topics in MDPI journals
Dr. Piotr Szweda

E-Mail Website
Guest Editor
Department of Pharmaceutical Technology and Biochemistry, Faculty of Chemistry, Gdansk University of Technology, Gdansk, Poland
Interests: bacteria and yeast drug resistance; staphylococcus aureus; Candida spp.; bee products; essential oils; peptidoglycan hydrolases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Urinary tract infections (UTIs) are among the most common and dangerous bacterial infections in humans. Antibiotic therapy is an important part of the therapeutic strategy for UTIs; however, in recent years, UTIs are becoming more challenging due to their increased resistance to routinely applied antibiotics. The increase in antibiotic resistance and the appearance of multi-drug resistant (MDR) pathogens in UTIs is associated with high rates of inadequate antibiotic empirical therapies. Increasing the frequency of MDR, especially in developing countries, results in the excessive use of broad-spectrum antibiotics, such as fluoroquinolones, cephalosporins and aminoglycosides, which also increase the cost of treatment and hospitalization. An understanding of regional differences concerning uropathogens responsible for UTIs and their antibiotic susceptibility is crucial for public health and important in empirical therapy to promote the proper use of existing chemotherapeutics. In addition, there is a urgent priority to find new antimicrobial agents, alternatives to antibiotics or additional prophylactic strategies to control UTIs, including biofilm formation in the urinary tract and on urinary catheters. Among these innovative agents, phytochemicals, preventive vaccines, probiotics, bacteriophages and nanoparticles seem to be the most promising.

Similar to the first edition of this Special Issue, manuscripts presenting all aspects of the challenges of drug resistance to uropathogens, as well as innovative approaches for the treatment of UITs, are welcome.

Here is the link to the first edition: https://www.mdpi.com/journal/antibiotics/special_issues/Uropathogens

Dr. Barbara Kot
Dr. Piotr Szweda
Guest Editors

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 100 words) can be sent to the Editorial Office for announcement on this website.

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

  • urinary tract infections (UTIs)
  • uropathogenes
  • antibiotic resistance of uropathogenes
  • treatment of UTIs
  • prevention of UTIs
  • alternatives to antibiotics methods of treatment and prophylactic of UTIs

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Published Papers (7 papers)

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Research

20 pages, 2328 KiB  
Article
General Characteristics and Current State of Antibiotic Resistance in Pediatric Urinary Tract Infection—A Single Center Experience
by Raluca Isac, Gabriela Doros, Cristiana-Alexandra Stolojanu, Ruxandra Maria Steflea, Ramona Florina Stroescu, Ioana-Cristina Olariu, Andrada-Mara Micsescu-Olah and Mihai Gafencu
Antibiotics 2024, 13(8), 684; https://doi.org/10.3390/antibiotics13080684 - 24 Jul 2024
Viewed by 1031
Abstract
Urinary tract infection (UTI) represents one of the most common bacterial infections in children, mainly caused by Gram-negative bacteria. Empirical antibiotic treatment is based on international and national guidelines for treating UTIs in children and is individualized with local antibiotic resistance patterns. The [...] Read more.
Urinary tract infection (UTI) represents one of the most common bacterial infections in children, mainly caused by Gram-negative bacteria. Empirical antibiotic treatment is based on international and national guidelines for treating UTIs in children and is individualized with local antibiotic resistance patterns. The aim of this study is to bring a clear view of present-day particularities of UTIs in children. Methods: We analyzed 210 positive urine cultures identified in 141 pediatric patients admitted to the hospital over a 6-month period. Results: The majority of patients were females (57%) with a median age of 5 years (IQR 12), while male patients revealed a median age of 2 (IQR 7). Most patients originated from urban areas (53%). Only 18 patients (12.76%) were identified with underlying Congenital Anomalies of the Kidney and Urinary Tract (CAKUT). Escherichia Coli was the most frequent pathogen. Increased antibiotic resistance was found in commonly-used antibiotics Ampicillin and Trimethoprim/Sulfamethoxazole, and in the case of patients with CAKUT. Suitable antibiotics for treating a Gram-negative UTI are aminoglycosides, Meropenem, third-generation Cephalosporins, and Nitrofurantoin. Vancomycin upholds efficacy in treating a Gram-positive pediatric UTI. Conclusion: Periodical analysis needs to be performed in order to constantly update clinicians on uropathogenic antibiotic resistance and optimal empirical treatment options. Full article
(This article belongs to the Special Issue Uropathogens—Antibiotic Resistance and Alternative Therapies, 2nd Edition)
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10 pages, 885 KiB  
Article
Macrolide Resistance in the Aerococcus urinae Complex: Implications for Integrative and Conjugative Elements
by Jyoti Lamichhane, Brian I. Choi, Natalie Stegman, Melline Fontes Noronha and Alan J. Wolfe
Antibiotics 2024, 13(5), 433; https://doi.org/10.3390/antibiotics13050433 - 10 May 2024
Cited by 1 | Viewed by 1555
Abstract
The recognition of the Aerococcus urinae complex (AUC) as an emerging uropathogen has led to growing concerns due to a limited understanding of its disease spectrum and antibiotic resistance profiles. Here, we investigated the prevalence of macrolide resistance within urinary AUC isolates, shedding [...] Read more.
The recognition of the Aerococcus urinae complex (AUC) as an emerging uropathogen has led to growing concerns due to a limited understanding of its disease spectrum and antibiotic resistance profiles. Here, we investigated the prevalence of macrolide resistance within urinary AUC isolates, shedding light on potential genetic mechanisms. Phenotypic testing revealed a high rate of macrolide resistance: 45%, among a total of 189 urinary AUC isolates. Genomic analysis identified integrative and conjugative elements (ICEs) as carriers of the macrolide resistance gene ermA, suggesting horizontal gene transfer as a mechanism of resistance. Furthermore, comparison with publicly available genomes of related pathogens revealed high ICE sequence homogeneity, highlighting the potential for cross-species dissemination of resistance determinants. Understanding mechanisms of resistance is crucial for developing effective surveillance strategies and improving antibiotic use. Furthermore, the findings underscore the importance of considering the broader ecological context of resistance dissemination, emphasizing the need for community-level surveillance to combat the spread of antibiotic resistance within the urinary microbiome. Full article
(This article belongs to the Special Issue Uropathogens—Antibiotic Resistance and Alternative Therapies, 2nd Edition)
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14 pages, 1809 KiB  
Article
In Vitro Activity of New β-Lactamase Inhibitor Combinations against blaNDM, blaKPC, and ESBL-Producing Enterobacteriales Uropathogens
by Lubna Razaq, Fakhur Uddin, Shahzad Ali, Shah Muhammad Abbasi, Muhammad Sohail, Nabila E. Yousif, Hala M. Abo-Dief and Zeinhom M. El-Bahy
Antibiotics 2023, 12(10), 1481; https://doi.org/10.3390/antibiotics12101481 - 25 Sep 2023
Cited by 3 | Viewed by 2077
Abstract
Antibiotic resistance in uropathogens has increased substantially and severely affected treatment of urinary tract infections (UTIs). Lately, some new formulations, including meropenem/vaborbactam (MEV), ceftazidime/avibactam (CZA), and ceftolozane/tazobactam (C/T) have been introduced to treat infections caused by drug-resistant pathogens. This study was designed to [...] Read more.
Antibiotic resistance in uropathogens has increased substantially and severely affected treatment of urinary tract infections (UTIs). Lately, some new formulations, including meropenem/vaborbactam (MEV), ceftazidime/avibactam (CZA), and ceftolozane/tazobactam (C/T) have been introduced to treat infections caused by drug-resistant pathogens. This study was designed to screen Enterobacteriales isolates from UTI patients and to assess their antimicrobial resistance pattern, particularly against the mentioned (new) antibiotics. Phenotypic screening of extended-spectrum β-lactamase (ESBL) and carbapenem resistance was followed by inhibitor-based assays to detect K. pneumoniae carbapenemase (KPC), metallo-β-lactamase (MBL), and class D oxacillinases (OXA). Among 289 Enterobacteriales, E. coli (66.4%) was the most predominant pathogen, followed by K. pneumoniae (13.8%) and P. mirabilis (8.3%). The isolates showed higher resistance to penicillins and cephalosporins (70–87%) than to non-β-lactam antimicrobials (33.2–41.5%). NDM production was a common feature among carbapenem-resistant (CR) isolates, followed by KPC and OXA. ESBL producers were susceptible to the tested new antibiotics, but NDM-positive isolates appeared resistant to these combinations. KPC-producers showed resistance to only C/T. ESBLs and carbapenemase encoding genes were located on plasmids and most of the genes were successfully transferred to recipient cells. This study revealed that MEV and CZA had significant activity against ESBL and KPC producers. Full article
(This article belongs to the Special Issue Uropathogens—Antibiotic Resistance and Alternative Therapies, 2nd Edition)
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9 pages, 815 KiB  
Article
Similarity Analysis of Klebsiella pneumoniae Producing Carbapenemases Isolated from UTI and Other Infections
by Agata Pruss, Paweł Kwiatkowski, Monika Sienkiewicz, Helena Masiuk, Agnieszka Łapińska, Barbara Kot, Zuzanna Kilczewska, Stefania Giedrys-Kalemba and Barbara Dołęgowska
Antibiotics 2023, 12(7), 1224; https://doi.org/10.3390/antibiotics12071224 - 24 Jul 2023
Cited by 3 | Viewed by 1968
Abstract
Klebsiella pneumoniae is an important opportunistic pathogen responsible for severe infections, mainly urinary tract infections (UTIs) and pneumonia. Hospital epidemic infections caused by multiresistant strains of carbapenemase-producing K. pneumoniae are the most concerning. NDM-producing strains are resistant to a wide range of antibiotics [...] Read more.
Klebsiella pneumoniae is an important opportunistic pathogen responsible for severe infections, mainly urinary tract infections (UTIs) and pneumonia. Hospital epidemic infections caused by multiresistant strains of carbapenemase-producing K. pneumoniae are the most concerning. NDM-producing strains are resistant to a wide range of antibiotics and have become the most significant threat. Determining the natural reservoirs and routes of infections is essential to end hospital outbreaks. Understanding the relatedness of K. pneumoniae strains is essential to determine the range and nature of the infection. The study compared phylogenetic relatedness between multiresistant K. pneumoniae strains isolated from hospitalized patients. Susceptibility to drugs and mechanisms of resistance were confirmed using phenotypic methods. PFGE was used to analyze the relatedness between strains. We analyzed 69 K. pneumoniae strains from various healthcare units. The isolates were mainly identified from urine. Strains were resistant to β-lactam antibiotics with β-lactamase inhibitors, cephalosporins, and quinolones. Their susceptibility to aminoglycosides and carbapenem antibiotics was diverse. Most of the isolated strains produced New Delhi metallo-ß-lactamase (NDM). Although K. pneumoniae strains were classified into several genotype clusters, closely related isolates were confirmed in the same hospital’s wards, and in two hospitals in the same province. Full article
(This article belongs to the Special Issue Uropathogens—Antibiotic Resistance and Alternative Therapies, 2nd Edition)
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11 pages, 252 KiB  
Article
Patients’ Experiences, Expectations, Motivations, and Perspectives around Urinary Tract Infection Care in General Practice: A Qualitative Interview Study
by Stefan Cox, Maud Vleeming, Wesley Giorgi, Geert-Jan Dinant, Jochen Cals and Eefje de Bont
Antibiotics 2023, 12(2), 241; https://doi.org/10.3390/antibiotics12020241 - 24 Jan 2023
Cited by 8 | Viewed by 3179
Abstract
While there are many alternatives to antibiotics for the symptomatic treatment of urinary tract infections (UTIs), their application in practice is limited. Among other things, general practitioners (GPs) often feel pressure from patients to prescribe antibiotics. To gain a better understanding of why [...] Read more.
While there are many alternatives to antibiotics for the symptomatic treatment of urinary tract infections (UTIs), their application in practice is limited. Among other things, general practitioners (GPs) often feel pressure from patients to prescribe antibiotics. To gain a better understanding of why this happens and where this pressure originates from, we investigated experiences, expectations, motivations, and perspectives of patients with UTIs in general practice. During this qualitative study we performed 14 semi-structured online interviews among female UTI patients in general practice. Interviews were based on a topic list derived from sensitising concepts. All the interviews were recorded, transcribed, and analysed using a constant comparative technique. Three main categories emerged from the data; (1) experienced versus unexperienced patients with UTI, (2) patient’s lack of knowledge, and (3) patients feeling understood. Inexperienced patients consult a general practitioner for both diagnosis and symptom relief, while experienced patients seem to consult specifically to obtain antibiotics. In addition, patients have a lack of knowledge with regard to the diagnosis, treatment, self-care, and cause of UTIs. Finally, patients’ satisfaction is increased by involving them more in the process of decision making, so they feel understood and taken seriously. Patients’ expectations in UTI management in general practice often arise during their first experience(s) and play a major role in subsequent episodes. In conclusion, preventing misconceptions is especially important in the inexperienced patient group, as this may prevent future overtreatment of UTIs. In addition, involving patients in the decision making process will lead to greater understanding of the GP’s treatment choices. Full article
(This article belongs to the Special Issue Uropathogens—Antibiotic Resistance and Alternative Therapies, 2nd Edition)
12 pages, 554 KiB  
Article
Prevalence, Clinico-Bacteriological Profile, and Antibiotic Resistance of Symptomatic Urinary Tract Infections in Pregnant Women
by Rajani Dube, Shatha Taher Salman Al-Zuheiri, Mariyam Syed, Lekshmi Harilal, Dean Allah Layth Zuhaira and Subhranshu Sekhar Kar
Antibiotics 2023, 12(1), 33; https://doi.org/10.3390/antibiotics12010033 - 25 Dec 2022
Cited by 7 | Viewed by 4612
Abstract
Background: Urinary tract infection (UTI) is a common complication in pregnancy. The prevalence varies between countries. This research aims at estimating the prevalence, clinico-bacteriological profile, antibiotic resistance, and risk factor analysis of symptomatic UTI in pregnancy. Method: This is a prospective observational study [...] Read more.
Background: Urinary tract infection (UTI) is a common complication in pregnancy. The prevalence varies between countries. This research aims at estimating the prevalence, clinico-bacteriological profile, antibiotic resistance, and risk factor analysis of symptomatic UTI in pregnancy. Method: This is a prospective observational study conducted at the Abdullah Bin Omran Hospital, RAK, UAE, from March 2019 to February 2020. All pregnant women attending the antenatal clinic during this period were given a pre-validated questionnaire for the symptoms of UTI. In symptomatic patients, urine was sent for microscopy, culture, and sensitivity. Women were treated for UTI and were followed up for the rest of the pregnancy. Data analysis was performed by SPSS software version 24 using descriptive statistics and comparisons with significance at a p-value of <0.05. Results: The prevalence of symptomatic UTI was 17.9%. E.coli was the commonest isolate followed by Group B streptococcus. The commonest symptom reported was loin pain and the most common risk factor was diabetes. Women with risk factors are significantly more likely to have culture-positive UTIs. Most of the pathogens were sensitive to cefuroxime and benzyl penicillin. Risk of preterm labor was higher. Conclusions: Regular antenatal care and routine urine testing in all visits are recommended for early detection and treatment of UTI. Full article
(This article belongs to the Special Issue Uropathogens—Antibiotic Resistance and Alternative Therapies, 2nd Edition)
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12 pages, 895 KiB  
Article
The Antimicrobial Resistance (AMR) Rates of Uropathogens in a Rural Western African Area—A Retrospective Single-Center Study from Kpando, Ghana
by Susanne Deininger, Therese Gründler, Sebastian Hubertus Markus Deininger, Karina Lütcke, Harry Lütcke, James Agbesi, Williams Ladzaka, Eric Gyamfi, Florian Wichlas, Valeska Hofmann, Eva Erne, Peter Törzsök, Lukas Lusuardi, Jan Marco Kern and Christian Deininger
Antibiotics 2022, 11(12), 1808; https://doi.org/10.3390/antibiotics11121808 - 13 Dec 2022
Cited by 7 | Viewed by 2231
Abstract
Little is known about the antimicrobial resistance (AMR) status of uropathogens in Western Africa. We performed a retrospective evaluation of urine cultures collected from the rural Margret Marquart Catholic Hospital, Kpando, Ghana during the time period from October 2019–December 2021. Urine samples from [...] Read more.
Little is known about the antimicrobial resistance (AMR) status of uropathogens in Western Africa. We performed a retrospective evaluation of urine cultures collected from the rural Margret Marquart Catholic Hospital, Kpando, Ghana during the time period from October 2019–December 2021. Urine samples from 348 patients (median age 40 years, 52.6% male) were examined. Of these, 125 (35.9%) showed either fungal or bacterial growth, including Escherichia coli in 48 (38.4%), Candida species (spp.) in 29 (23.2%), Klebsiella spp. in 27 (21.6%), Proteus spp. in 12 (9.6%), Citrobacter spp. in 10 (8.0%), Salmonella spp. in 4 (3.2%), Staphylococcus spp. in 3 (2.4%), and Pseudomonas spp. in 2 (1.6%) cases. Two bacterial spp. were detected in 7 samples (5.6%). Antibiotic susceptibility testing showed resistance to a mean 8.6 out of 11 tested antibiotics per patient. Significant predictors (p < 0.05) of bacterial growth were age (OR 1.03), female sex (OR 3.84), and the number of pus cells (OR 1.05) and epithelial cells (OR 1.07) in urine microscopy. We observed an alarmingly high AMR rate among the uropathogens detected, even to reserve antibiotics. A similar resistance profile can be expected in West African patients living in high-income countries. These observations warrant the implementation of restrictive antibiotic protocols, together with the expansion of urine culture testing capacities, improvement of documentation and reporting of AMR rates, and continued research and development of new antibiotic therapies in order to stem the progression of AMR in this West African region. Full article
(This article belongs to the Special Issue Uropathogens—Antibiotic Resistance and Alternative Therapies, 2nd Edition)
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