Clinical Setting Comparative Analysis of Uropathogens and Antibiotic Resistance: A Retrospective Study Spanning the Coronavirus Disease 2019 Pandemic.

Publication date: Feb 01, 2024

Antimicrobial resistance (AMR) in uropathogens has been increasing in Australia. Many nations observed heightened AMR during the coronavirus disease 2019 (COVID-19) pandemic, but it is not known how this may vary across clinical settings and in nations with lower infection rates. We investigated the uropathogen composition and corresponding antibiotic resistance of 775 559 Australian isolates from the community, hospitals, and aged care facilities before (2016-2019) and during (2020-2022) the COVID-19 pandemic. A mathematical model was developed to predict the likelihood of resistance to currently recommended antibiotics for treating urinary tract infections (UTIs). Among uropathogens originating from the community, hospitals, and aged care facilities, Escherichia coli accounted for 71. 4%, 57. 6%, and 65. 2%, respectively. During the COVID-19 pandemic period, there was an increase in UTIs caused by E coli across all settings. Uropathogens from aged care and hospitals frequently showed higher resistance to antibiotics compared to those isolated from the community. Interestingly, AMR among uropathogens showed a declining trend during the COVID-19 pandemic. Based on the resistance patterns of the past 3 years, our modeling predicted that 30%, 42. 6%, and 38. 8% of UTIs in the community, hospitals, and aged care facilities, respectively, would exhibit resistance to trimethoprim treatment as empirical therapy. In contrast, resistance to nitrofurantoin was predicted to be 14. 6%, 26%, and 24. 1% from these 3 respective settings. Empirical therapy of UTIs in Australia with trimethoprim requires evaluation due to high rates of resistance observed across clinical settings.

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Concepts Keywords
Antibiotic aged care facilities
Australia antibiotic resistance
Coronavirus trimethoprim
Uropathogens urinary tract infection
uropathogens

Semantics

Type Source Name
disease IDO antibiotic resistance
disease MESH Coronavirus Disease 2019
disease MESH infection
disease MESH urinary tract infections
drug DRUGBANK Trimethoprim
drug DRUGBANK Nitrofurantoin
drug DRUGBANK Methylphenidate
drug DRUGBANK Coenzyme M
disease MESH Infectious Diseases
pathway REACTOME Reproduction
disease MESH cystitis
drug DRUGBANK Amoxicillin
drug DRUGBANK Clavulanic acid
drug DRUGBANK Indoleacetic acid
disease VO population
disease IDO susceptibility
drug DRUGBANK Ademetionine
disease IDO blood
disease IDO pathogen
disease VO frequency
drug DRUGBANK Estrone sulfate
disease VO organ
drug DRUGBANK Cephalexin

Original Article

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