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Isolation and Identification of Waterborne Antibiotic-Resistant Bacteria and Molecular Characterization of their Antibiotic Resistance Genes
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Published on: March 3, 2023

Determinants of Multidrug Resistance Among Gram-Positive Uropathogens in Central Portugal: A 5-Year Retrospective

Muhammad Adnan1, Patrícia Coelho2,3, Sónia Mateus2,3

  • 1Health Research Institute, National Institute of Health, Islamabad, Pakistan, iss.it.

International Journal of Microbiology
|July 28, 2026
PubMed

Insights

Multidrug resistance (MDR) is high in Gram-positive cocci (GPC) causing urinary tract infections (UTIs), especially in older patients. Oxazolidinones and cyclic lipopeptides remain effective last-line treatments.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Clinical Medicine

Background:

  • Urinary tract infections (UTIs) are common bacterial infections globally.
  • Gram-negative bacteria are typical uropathogens, but Gram-positive cocci (GPC) are emerging threats.
  • Multidrug resistance (MDR) in GPC UTIs requires urgent investigation.

Purpose of the Study:

  • To determine the prevalence of MDR among GPC UTIs.
  • To identify predictors of MDR in GPC UTIs.
  • To assess antimicrobial resistance trends and effective last-line therapies.

Main Methods:

  • Retrospective analysis of 655 patients with culture-confirmed GPC UTIs.
  • Data collected from a Central Portugal hospital between 2018 and 2022.
  • Multivariate analysis to identify MDR predictors and temporal trends.

Main Results:

  • Overall MDR prevalence was 83.7%, with 98.2% MDR in Enterococcus spp.
  • Older age was an independent predictor of MDR.
  • Staphylococcus and Streptococcus species showed lower MDR odds than Enterococcus.
  • MDR risk increased in 2021-2022.
  • Oxazolidinones and cyclic lipopeptides maintained high activity.

Conclusions:

  • GPC UTIs exhibit high and increasing MDR rates.
  • Older age and Enterococcus species are key risk factors for MDR.
  • Last-line antibiotics like oxazolidinones and cyclic lipopeptides are crucial for MDR GPC UTIs.
Keywords:
Gram-positive cocciPortugalantibacterial agentsantimicrobial stewardshipurinary tract infections

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