Annual changes of antimicrobial resistance and antibiotic preference in urology inpatient group; a tertiary hospital...

To present changes in our institution's antibiotic prescription patterns and resistance status over time, as well as the characteristics of the urology inpatient population and and their association with bacterial resistance.

Patients who had urinary tract infection and tested positive for blood or urine cultures were included. Patient data and demographics were recorded retrospectively. The study evaluated annual changes in bacterial resistance and first-choice antibiotics, including a linear resistance trend analysis for each antibiotics. We analyzed the frequency of resistant bacterial isolates over time and their correlations with patient characteristics.

From January 2015 to December 2020, 1,092 unique patients (> 18 years old, 71% male) were included. The predominant causative agent in both urine and blood cultures was Escherichia coli (33.9% in urine and 41% in blood). Enterococcus strains were the second most frequently identified agent in urine cultures (21.4%). Cephalosporins and carbapenems were the most commonly prescribed antibiotics, with a marked increase in carbapenem use, reaching 52% in 2020. Extended Spectrum Beta-Lactamase (ESBL)-producing bacteria accounted for 44% of isolates, multidrug-resistant (MDR) bacteria for 29%, and extensively drug-resistant (XDR) bacteria for 4%. Prior antibiotic use was significantly associated with MDR isolates (p = 0.002, OR 1.61, 95% CI 1.18-2.19).

Urology inpatients demonstrate high rates of antimicrobial resistance. Periodic changes in antibiotic use are strongly associated with resistance patterns. These findings highlight the importance of antimicrobial stewardship programs and regular review of empirical treatment strategies.