Nonenteric Pathogens in Urinary Tract Infections: Epidemiology and Resistance Patterns in Albania

Area of Science:

• Microbiology
• Infectious Diseases
• Public Health

Background:

• Antibiotic resistance poses a global health threat, complicating urinary tract infection (UTI) treatment.
• Nonenteric pathogens, including Pseudomonas aeruginosa and Enterococcus spp., are increasingly implicated in UTIs and exhibit complex resistance mechanisms.

Purpose of the Study:

• To determine the prevalence, resistance patterns, and multidrug resistance (MDR) of nonenteric pathogens in community-acquired UTIs in Albania.
• To identify common nonenteric UTI pathogens and their susceptibility profiles to various antibiotics.

Main Methods:

• A prospective study analyzed 550 urine cultures from an Albanian outpatient clinic (September 2023–September 2024).
• Bacterial identification and antibiotic susceptibility testing were performed using the VITEK 2 system for 11 antibiotics.
• Statistical analysis identified significant resistance patterns and MDR prevalence.

Main Results:

• Nonenteric pathogens accounted for 27.7% of positive UTI cultures, predominantly in females and young adults.
• Enterococcus faecalis (15.2%) and Pseudomonas aeruginosa (9.1%) were the most frequent nonenteric pathogens.
• High resistance rates were observed for Pseudomonas aeruginosa (tigecycline 91.2%, levofloxacin 38.2%) and Enterococcus faecalis (vancomycin 53.6%). MDR was highest in P. aeruginosa (26.5%).

Conclusions:

• Community-acquired UTIs in Albania show a high prevalence of nonenteric pathogens with concerning multidrug resistance rates.
• Urgent implementation of standardized treatment protocols, improved antibiotic stewardship, and ongoing resistance surveillance are critical for effective patient care and combating antibiotic resistance.