Journal
LIFE-BASEL
Volume 10, Issue 2, Pages -Publisher
MDPI
DOI: 10.3390/life10020016
Keywords
clinical microbiology; indicators; urinary tract infection; Gram-negative; drug resistance; usual drug resistance; difficult-to-treat resistance; UDR; DTR; MDR; XDR; PDR
Categories
Funding
- ESCMID Mentorship and Observership Programme
Ask authors/readers for more resources
Classical resistance classifications (multidrug resistance [MDR], extensive drug resistance [XDR], pan-drug resistance [PDR]) are very useful for epidemiological purposes, however, they may not correlate well with clinical outcomes, therefore, several novel classification criteria (e.g., usual drug resistance [UDR], difficult-to-treat resistance [DTR]) were introduced for Gram-negative bacteria in recent years. Microbiological and resistance data was collected for urinary tract infections (UTIs) retrospectively, corresponding to the 2008.01.01-2017.12.31. period. Isolates were classified into various resistance categories (wild type/susceptible, UDR, MDR, XDR, DTR and PDR), in addition, two new indicators (modified DTR; mDTR and mcDTR) and a predictive composite score (pMAR) were introduced. Results: n = 16,240 (76.8%) outpatient and n = 13,386 (69.3%) inpatient UTI isolates were relevant to our analysis. Citrobacter-Enterobacter-Serratia had the highest level of UDR isolates (88.9%), the Proteus-Providencia-Morganella group had the highest mDTR levels. MDR levels were highest in Acinetobacter spp. (9.7%) and Proteus-Providencia-Morganella (9.1%). XDR- and DTR-levels were higher in non-fermenters (XDR: 1.7%-4.7%. DTR: 7.3%-7.9%) than in Enterobacterales isolates (XDR: 0%-0.1%. DTR: 0.02%-1.5%). Conclusions: The introduction of DTR (and its' modifications detailed in this study) to the bedside and in clinical practice will definitely lead to substantial benefits in the assessment of the significance of bacterial resistance in human therapeutics.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available