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Author Spotlight: Understanding and Detecting Environmental Antimicrobial Resistance by Combining Culture-Based Techniques and Genomics
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The global burden of antimicrobial resistance - urinary tract infections

Sibylle Von Vietinghoff1, Olga Shevchuk2, Ulrich Dobrindt3

  • 1University Hospital Bonn, Medical Clinic 1, Section for Nephrology and University  Bonn, Germany.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|October 27, 2023
PubMed

Insights

Antimicrobial resistance (AMR) is a growing threat, especially in urinary tract infections (UTIs) caused by Gram-negative bacteria. New strategies, including antimicrobial peptides and bacteriophages, are needed to combat resistant uropathogens.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Antimicrobial resistance (AMR) is a critical global health issue, accelerated by antibiotic use, particularly in Gram-negative pathogens.
  • Urinary tract infections (UTIs) are frequently caused by Gram-negative bacteria, which exhibit high adaptation and possess specific virulence and AMR factors.
  • The interplay between resistance and virulence in uropathogens is complex, with beta-lactamases being a prominent AMR mechanism.

Purpose of the Study:

  • To summarize current knowledge on clinical and microbiological AMR in UTIs.
  • To discuss the factors influencing AMR prevalence in UTIs, including antibiotic consumption and urinary tract physiology.
  • To explore innovative, non-antibiotic approaches for combating uropathogenic microbes.

Main Methods:

  • Review of existing literature on antimicrobial resistance in UTIs.
  • Analysis of factors contributing to AMR emergence, such as antibiotic history and host-pathogen interactions.
  • Evaluation of alternative treatments like antimicrobial peptides and bacteriophages.

Main Results:

  • AMR in UTIs is influenced by patient populations, antibiotic history, and urinary tract conditions.
  • Uropathogens demonstrate complex mechanisms for acquiring both virulence and AMR.
  • Antimicrobial peptides and bacteriophage therapy show promise as alternatives to antibiotics.

Conclusions:

  • Addressing AMR in UTIs requires a multifaceted approach beyond traditional antibiotics.
  • Innovative strategies, including risk prediction and non-antibiotic therapies, are essential for future management of UTIs.
  • Further research into antimicrobial peptides and bacteriophages is warranted for effective treatment of resistant uropathogen infections.
Keywords:
antimicrobial peptidesantimicrobial resistanceevolutionpatient populationurinary tract infections

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