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Rising threats and evolving trends: Five years of urinary tract infection prevalence in a Portuguese hospital

dc.contributor.authorRodrigues, Francisco
dc.contributor.authorPatricia Coelho
dc.contributor.authorMateus, Sónia
dc.contributor.authorCastelo BrancoMiguel
dc.date.accessioned2025-09-19T10:50:42Z
dc.date.available2025-09-19T10:50:42Z
dc.date.issued2025
dc.date.updated2025-09-16T08:51:07Z
dc.descriptionThe study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the University of Beira Interior (CE-UBI-Pj-2023-020) on 19 April 2023. Due to ethical restrictions and the protection of participants’ confidentiality, the data are not publicly available. However, the datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
dc.description.abstractBackground/Objective: Urinary tract infections (UTIs) are a significant public health concern worldwide, yet longitudinal data from Portuguese hospital settings remain limited. This study aimed to characterize epidemiological trends, microbial etiology, antimicrobial resistance patterns, and associated risk factors of UTIs over a five-year period (2018–2022) in a central Portuguese hospital. Methods: In this retrospective observational study, 23,682 positive urine cultures were analyzed from specimens collected between anuary 2018 and December 2022. Data were extracted from the laboratory information system and included patient demographics, clinical service of origin, isolated microorganisms, resistance profiles, and annual antibiotic consumption (Defined Daily Dose (DDD) per 1000 patient-days). UTI prevalence was calculated as the proportion of positive cultures among all urine samples processed annually. Results: The positivity rate increased from 18.7% in 2018 to 22.7% in 2022, with a peak in 2019. Women represented around 70% of cases throughout the study period. Most infections originated from inpatient wards, followed by emergency services. Escherichia coli remained the leading pathogen (≈62%), followed by Klebsiella pneumoniae (≈14%) and Enterococcus faecalis (≈8%). Risk factors included catheterization (37.2%), prior UTI history (22.1%), and diabetes mellitus (18.5%). Longer hospital stays (>7 days) were associated with increased positivity. For E. coli, resistance ranged from 2% (amikacin) to 41% (ampicillin), with increasing resistance to ertapenem and fosfomycin and decreasing resistance to several key antibiotics. K. pneumoniae showed 4–36% resistance across antimicrobials, with notable increases for fosfomycin, meropenem, and cefuroxime axetil. Antibiotic usage trends reflected these patterns, with declining use of amikacin and rising use of cefuroxime axetil and meropenem. Conclusions: Over the five-year period, both UTI prevalence and resistance to critical antimicrobials increased, reinforcing the need to update empirical treatment guidelines. Identified risk factors may inform targeted prevention strategies. Ongoing surveillance and antimicrobial stewardship are crucial to mitigate the rising burden of UTIs and resistancepor
dc.description.versionN/A
dc.identifier.citationRODRIGUES, F.J.B. [et al.] (2025) - Rising threats and evolving trends: Five years of urinary tract infection prevalence in a Portuguese hospital. Clin. Pract. 15:100. DOI: 10.3390/clinpract15060100
dc.identifier.doi10.3390/clinpract15060100en_US
dc.identifier.slugcv-prod-4564163
dc.identifier.urihttp://hdl.handle.net/10400.11/10302
dc.language.isoeng
dc.peerreviewedyes
dc.publisherMDPI
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectUrinary tract infections (UTIs)
dc.subjectAntibiotic resistance
dc.subjectAntibiotic stewardship
dc.subjectEpidemiology of UTIs
dc.subjectAntimicrobial consumption
dc.subjectPortugal
dc.titleRising threats and evolving trends: Five years of urinary tract infection prevalence in a Portuguese hospitaleng
dc.typeresearch articleen_US
dspace.entity.typePublication
oaire.citation.titleClinics and Practiceen_US
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameRodrigues
person.familyNameCoelho
person.givenNameFrancisco
person.givenNamePatricia Margarida dos Santos Carvalheiro
person.identifier2982790
person.identifier.ciencia-id7A18-045E-330C
person.identifier.ciencia-idFC1B-BB26-3206
person.identifier.orcid0000-0001-8405-4249
person.identifier.orcid0000-0002-9862-0691
person.identifier.ridJTV-3288-2023
person.identifier.scopus-author-id57214122402
rcaap.cv.cienciaid7A18-045E-330C | Francisco José Barbas Rodrigues
rcaap.rightsopenAccessen_US
relation.isAuthorOfPublicationd496c83f-3a6b-424e-ba10-452ce609d597
relation.isAuthorOfPublicationaf807030-f5b4-4634-a7c5-77749716e4f8
relation.isAuthorOfPublication.latestForDiscoveryd496c83f-3a6b-424e-ba10-452ce609d597

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