Abstract:
Introduction
Urinary tract infections (UTIs) represent a significant public health
issue, ranking among the most common bacterial infections globally.
The pathogens involved in UTIs are increasingly developing
resistance mechanisms to antibiotics, complicating treatment and
raising the risk of complications. The analysis of international
literature provides insight into current trends regarding the
susceptibility of these microorganisms to antimicrobial agents.
Material and methods
A systematic review was conducted using international databases
(PubMed, ScienceDirect, Scopus), covering the period 2015–2024.
The review included observational studies, multicenter clinical
research, and microbiological surveillance reports concerning the
susceptibility profiles of the main species involved in UTIs:
Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis,
Enterococcus faecalis, and Pseudomonas aeruginosa.
Rezults
The analysis of international literature confirms the dominance of E.
coli as the primary uropathogen. Resistance rates among E. coli
strains are concerning, with up to 75% showing resistance to
fluoroquinolones and third- and fourth-generation cephalosporins. Additionally, extended-spectrum beta-lactamase (ESBL)-producing E.
coli strains have become increasingly prevalent, especially in
hospitalized patients and individuals with recurrent infections. K.
pneumoniae, the second most frequently isolated pathogen in UTIs,
demonstrates high levels of multidrug resistance. Carbapenem
resistance has been documented in 26.4% of isolates, and resistance
to aminoglycosides and cephalosporins is also on the rise.
Pseudomonas aeruginosa has shown an alarming resistance profile in
nosocomial UTIs. Studies report resistance rates of 69% to
carbapenems, 75% to aminoglycosides, and 65.4% to thirdgeneration
cephalon-sporins. P. mirabilis, although less prevalent, is
another important pathogen, particularly in catheter-associated
UTIs. It exhibits notable resistance to tetracyclines and trimethoprimsulfamethoxazole.
E. faecalis have shown high resistance rates to
commonly used antibiotics: 62.43% for E. faecalis and 65.18% for E.
faecium. Moreover, vancomycin-resistant enterococci are
increasingly reported, complicating treatment and infection control
measures.
Conclusions
The increased resistance of UTI pathogens to commonly used
antibiotics highlights the need for continuous monitoring of
susceptibility profiles and the adaptation of therapeutic guidelines
based on local and regional data. The implementation of effective
antibiotic stewardship strategies and the promotion of rational
antimicrobial use are essential for preventing the spread of
resistance and ensuring the efficacy of available treatments.
