Does the COVID Pandemic Modify the Antibiotic Resistance of Uropathogens in Female Patients? A New Storm?

Overview

Journal Antibiotics (Basel)

Specialty Pharmacology

Date 2022 Mar 25

PMID 35326839

Authors

Cristian Mares

Razvan-Cosmin Petca

Aida Petca

Razvan-Ionut Popescu

Viorel Jinga

Affiliations

Soon will be listed here.

Abstract

Urinary tract infections (UTIs) represent a common pathology among female patients, leading to overprescribing antibiotics, globally. The emergence of the COVID-19 pandemic has dramatically increased the incidence of this particular viral pneumonia with secondary bacterial superinfection, resulting in continuous therapeutic or prophylactic recommendations of antibiotic treatment; thus, an updated analysis of current antimicrobial resistance among uropathogens is mandatory. This cross-sectional retrospective study conducted in two university hospitals in Bucharest, Romania analyzed 2469 positive urine cultures, among two different periods of 6 months, before and during the COVID-19 pandemic. The most common pathogen was 1505 (60.95%), followed by spp. 426 (17.25%). spp. was the leading Gram-positive pathogen 285 (11.54%). In gram negative bacteria, in almost all cases, an increased in resistance was observed, but the highest increase was represented by quinolones in spp., from 16.87% to 35.51% and from 30.3% to 77.41%; a significant increase in resistance was also observed for carbapenems. Surprisingly, a decrease in resistance to Penicillin was observed in spp., but the overall tendency of increased resistance is also maintained for gram positive pathogens. The lack of data on the influence of the COVID-19 pandemic on uropathogens' resistance promotes these findings as important for every clinician treating UTIs and for every specialist in the medical field in promoting reasonable recommendations of antibiotic therapies.

Citing Articles

Bacterial Infections, Trends, and Resistance Patterns in the Time of the COVID-19 Pandemic in Romania-A Systematic Review.

Vulcanescu D, Bagiu I, Avram C, Oprisoni L, Tanasescu S, Sorescu T Antibiotics (Basel). 2025; 13(12.

PMID: 39766609 PMC: 11726834. DOI: 10.3390/antibiotics13121219.

Antibiotic Resistance Pattern of Pathogens Isolated from Pediatric Patients during and after the COVID-19 Pandemic.

Golli A, Popa S, Cara M, Stoica G, Fortofoiu D, Stoica M Antibiotics (Basel). 2024; 13(10).

PMID: 39452232 PMC: 11505055. DOI: 10.3390/antibiotics13100966.

Global status of antimicrobial resistance in clinical Enterococcus faecalis isolates: systematic review and meta-analysis.

Guan L, Beig M, Wang L, Navidifar T, Moradi S, Motallebi Tabaei F Ann Clin Microbiol Antimicrob. 2024; 23(1):80.

PMID: 39182092 PMC: 11344933. DOI: 10.1186/s12941-024-00728-w.

Antibiotic Resistance Trends in Uropathogens during the COVID-19 Pandemic in Western Romania: A Cross-Sectional Study.

Hogea E, Muntean A, Bratosin F, Bogdan I, Plavitu O, Fratutu A Antibiotics (Basel). 2024; 13(6).

PMID: 38927179 PMC: 11201005. DOI: 10.3390/antibiotics13060512.

The Prevalence of Multidrug-Resistant Uropathogenic Bacterial Profile With Antibiotic Susceptibility Patterns Among the Community and Hospitalized Patients During COVID Waves.

Shawkat N, Yassin N Cureus. 2024; 16(5):e60613.

PMID: 38894805 PMC: 11185838. DOI: 10.7759/cureus.60613.

References

Jellheden B, Norrby R, Sandberg T . Symptomatic urinary tract infection in women in primary health care. Bacteriological, clinical and diagnostic aspects in relation to host response to infection. Scand J Prim Health Care. 1996; 14(2):122-8. DOI: 10.3109/02813439608997082. View

Gupta K, Sahm D, Mayfield D, Stamm W . Antimicrobial resistance among uropathogens that cause community-acquired urinary tract infections in women: a nationwide analysis. Clin Infect Dis. 2001; 33(1):89-94. DOI: 10.1086/320880. View

Lansbury L, Lim B, Baskaran V, Lim W . Co-infections in people with COVID-19: a systematic review and meta-analysis. J Infect. 2020; 81(2):266-275. PMC: 7255350. DOI: 10.1016/j.jinf.2020.05.046. View

Stefaniuk E, Suchocka U, Bosacka K, Hryniewicz W . Etiology and antibiotic susceptibility of bacterial pathogens responsible for community-acquired urinary tract infections in Poland. Eur J Clin Microbiol Infect Dis. 2016; 35(8):1363-9. PMC: 4947106. DOI: 10.1007/s10096-016-2673-1. View

Hrbacek J, cermak P, Zachoval R . Current Antibiotic Resistance Trends of Uropathogens in Central Europe: Survey from a Tertiary Hospital Urology Department 2011-2019. Antibiotics (Basel). 2020; 9(9). PMC: 7559630. DOI: 10.3390/antibiotics9090630. View

Milas S, Poncelet A, Buttafuoco F, Pardo A, Lali S, Cherifi S . Antibiotic use in patients with Coronavirus disease 2019 (COVID-19): outcomes and associated factors. Acta Clin Belg. 2021; 77(3):579-587. DOI: 10.1080/17843286.2021.1916300. View

Salvatore S, Salvatore S, Cattoni E, Siesto G, Serati M, Sorice P . Urinary tract infections in women. Eur J Obstet Gynecol Reprod Biol. 2011; 156(2):131-6. DOI: 10.1016/j.ejogrb.2011.01.028. View

Kwon K, Kim B, Ryu S, Wie S, Jo H, Park S . Changes in Clinical Characteristics of Community-Acquired Acute Pyelonephritis and Antimicrobial Resistance of Uropathogenic in South Korea in the Past Decade. Antibiotics (Basel). 2020; 9(9). PMC: 7559700. DOI: 10.3390/antibiotics9090617. View

Chibelean C, Petca R, Mares C, Popescu R, Eniko B, Mehedintu C . A Clinical Perspective on the Antimicrobial Resistance Spectrum of Uropathogens in a Romanian Male Population. Microorganisms. 2020; 8(6). PMC: 7357063. DOI: 10.3390/microorganisms8060848. View

10.

Gajdacs M, Abrok M, Lazar A, Burian K . Increasing relevance of Gram-positive cocci in urinary tract infections: a 10-year analysis of their prevalence and resistance trends. Sci Rep. 2020; 10(1):17658. PMC: 7573585. DOI: 10.1038/s41598-020-74834-y. View

11.

Levison M, Kaye D . Treatment of complicated urinary tract infections with an emphasis on drug-resistant gram-negative uropathogens. Curr Infect Dis Rep. 2013; 15(2):109-15. DOI: 10.1007/s11908-013-0315-7. View

12.

Minardi D, dAnzeo G, Cantoro D, Conti A, Muzzonigro G . Urinary tract infections in women: etiology and treatment options. Int J Gen Med. 2011; 4:333-43. PMC: 3108201. DOI: 10.2147/IJGM.S11767. View

13.

Flores-Mireles A, Walker J, Caparon M, Hultgren S . Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015; 13(5):269-84. PMC: 4457377. DOI: 10.1038/nrmicro3432. View

14.

Langford B, So M, Raybardhan S, Leung V, Soucy J, Westwood D . Antibiotic prescribing in patients with COVID-19: rapid review and meta-analysis. Clin Microbiol Infect. 2021; 27(4):520-531. PMC: 7785281. DOI: 10.1016/j.cmi.2020.12.018. View

15.

Getahun H, Smith I, Trivedi K, Paulin S, Balkhy H . Tackling antimicrobial resistance in the COVID-19 pandemic. Bull World Health Organ. 2020; 98(7):442-442A. PMC: 7375214. DOI: 10.2471/BLT.20.268573. View

16.

Polly M, de Almeida B, Lennon R, Cortes M, Costa S, Guimaraes T . Impact of the COVID-19 pandemic on the incidence of multidrug-resistant bacterial infections in an acute care hospital in Brazil. Am J Infect Control. 2021; 50(1):32-38. PMC: 8457917. DOI: 10.1016/j.ajic.2021.09.018. View

17.

Laxminarayan R, Duse A, Wattal C, Zaidi A, Wertheim H, Sumpradit N . Antibiotic resistance-the need for global solutions. Lancet Infect Dis. 2013; 13(12):1057-98. DOI: 10.1016/S1473-3099(13)70318-9. View

18.

Scholes D, Hooton T, Roberts P, Stapleton A, Gupta K, Stamm W . Risk factors for recurrent urinary tract infection in young women. J Infect Dis. 2000; 182(4):1177-82. DOI: 10.1086/315827. View

19.

Stamm W, Norrby S . Urinary tract infections: disease panorama and challenges. J Infect Dis. 2001; 183 Suppl 1:S1-4. DOI: 10.1086/318850. View

20.

Gasperini B, Cherubini A, Lucarelli M, Espinosa E, Prospero E . Multidrug-Resistant Bacterial Infections in Geriatric Hospitalized Patients before and after the COVID-19 Outbreak: Results from a Retrospective Observational Study in Two Geriatric Wards. Antibiotics (Basel). 2021; 10(1). PMC: 7835859. DOI: 10.3390/antibiotics10010095. View