Antibiotic Resistance Changes in Gram-Positive Bacteria from Urine Cultures: Development Analysis in a Health Area of South-East Spain
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Fernández Espigares, Luis; Hernández Chico, Itahisa; Expósito Ruiz, Manuela; Gutiérrez Fernández, JoséMateria
Significant bacteriuria Gram-positive bacteria Antibiotic resistances Urinary tract infections Enterococcus Staphylococcus Streptococcus
Fecha
2023-06-30Referencia bibliográfica
Fernández-Espigares, L.; Hernández-Chico, I.; Expósito-Ruiz, M.; Rosales-Castillo, A.; Navarro-Marí, J.M.; Gutiérrez-Fernández, J. Antibiotic Resistance Changes in Gram-Positive Bacteria from Urine Cultures: Development Analysis in a Health Area of South-East Spain. Antibiotics 2023, 12, 1133. [https://doi.org/10.3390/antibiotics12071133]
Resumen
This study analyzed the epidemiology and antibiotic susceptibility profile of significant
bacteriuria and assessed the impact of adopting EUCAST criteria on antibiotic resistances. A systematic
review was performed on publications in English or Spanish between 1 January 2010 and
30 June 2021 on the susceptibility of Gram-positive bacteria isolated in urinary samples in Europe.
A retrospective descriptive study was also conducted on the results of 21,838 urine cultures with
presumptive urinary tract infection (UTI) obtained during the past five years by the Department
of Microbiology of the Virgen de las Nieves University Hospital (Granada, Spain). The activity
of various antibiotics was determined, differentiated among various populations, and interpretations
compared according to the application of EUCAST or CLSI criteria. Among 21,838 cases
of significant bacteriuria, 27.69% were by Gram-positive bacteria, which were Enterococcus faecalis
in 19.04% and Enterococcus faecium in 3.92%. The susceptibility profile remained stable for most
antibiotics except for levofloxacin for E. faecalis and Staphylococcus aureus and nitrofurantoin for
E. faecium. The resistance of Enterococcus spp. and Staphylococcus spp. to glycopeptides was exceptionally
low in our setting. No significant difference in the prevalence ofmethicillin-resistant Staphylococcus
aureus was observed between hospital (26.67%) and community (28.85%) samples. Resistances in our
local setting remain stable and appear to be lower than reported in other studies. The adoption of
EUCAST vs. CLSI criteria did not produce a general change in resistance rates. Findings suggest
the need to revise certain empirical criteria, such as aminoglycoside synergy for Enterococcus and for
community-origin S. aureus.