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The changing landscape of urinary tract infections: Epidemiology, pathogen distribution and antimicrobial resistance over six years

2026Artigo de investigação Acesso aberto
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datacite.subject.fosCiências Médicas
dc.contributor.authorLopes, Sara
dc.contributor.authorCoelho, Patricia
dc.contributor.authorChaves , Catarina
dc.contributor.authorMateus, Sónia
dc.contributor.authorMetello, João
dc.contributor.authorRodrigues, Francisco
dc.date.accessioned2026-10-02T12:02:39Z
dc.date.available2026-10-02T12:02:39Z
dc.date.issued2026
dc.date.updated2026-10-01T14:16:31Z
dc.description.abstractBackground: Urinary tract infections (UTIs) are among the most common bacterial infections worldwide and remain a major cause of antimicrobial prescribing in both Community and hospital settings. Continuous epidemiological surveillance is essential to monitor changes in uropathogen distribution and antimicrobial resistance, particularly in aging populations. Methods: A retrospective observational study was conducted using urine culture data from a Portuguese tertiary healthcare network between January 2020 and December 2025. Demographic, microbiological, and antimicrobial susceptibility data were extracted from the laboratory information system. After applying predefined exclusion criteria, 44,596 positive urine cultures corresponding to distinct infectious episodes were included. Pathogen distribution, temporal trends, polymicrobial infections and antimicrobial susceptibility patterns were analyzed according to age, sex, and healthcare setting. Results: During the study period, 165,269 urine samples were processed, yielding 44,596 positive urine cultures. Women accounted for most infections, while individuals aged ≥65 years represented the largest patient group. Of all positive cultures, 41,555 (93.2%) were monomicrobial and 3041 (6.8%) were polymicrobial. Escherichia coli was the predominant uropathogen (49.6%), followed by Klebsiella pneumoniae (17.4%), Proteus mirabilis (7.0%), Enterococcus faecalis (5.3%), and Pseudomonas aeruginosa (5.1%). The overall microbiological profile remained relatively stable throughout the six-year period. Antimicrobial susceptibility testing demonstrated preserved activity of fosfomycin against the principal Enterobacterales, whereas resistance to fluoroquinolones and trimethoprim–sulfamethoxazole remained substantial. Polymicrobial infections occurred predominantly among older and hospitalized patients. Conclusions: This large-scale six-year surveillance study provides a comprehensive overview of the epidemiology of urinary tract infections within a Portuguese tertiary healthcare network. The findings confirm the continued predominance of Escherichia coli, highlight the growing burden of UTIs among older adults, and emphasize the importance of continuous local microbiological surveillance to support empirical antimicrobial therapy, antimicrobial stewardship, and future public health strategies.eng
dc.description.versionN/A
dc.identifier.citationLOPES, Sara [et al.] (2026) - The changing landscape of urinary tract infections: Epidemiology, pathogen distribution and antimicrobial resistance over six years. Bacteria. DOI: 10.3390/bacteria5040061
dc.identifier.doi10.3390/bacteria5040061en_US
dc.identifier.slugcv-prod-5111720
dc.identifier.urihttp://hdl.handle.net/10400.11/11011
dc.language.isoeng
dc.peerreviewedyes
dc.publisherMDPI
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectUrinary tract infections
dc.subjectUrine culture
dc.subjectAntimicrobial resistance
dc.subjectUropathogens
dc.subjectEscherichia coli
dc.subjectEpidemiological surveillance
dc.subjectPolymicrobial infection
dc.subjectPortugal
dc.titleThe changing landscape of urinary tract infections: Epidemiology, pathogen distribution and antimicrobial resistance over six yearseng
dc.typeresearch articleen_US
dspace.entity.typePublication
oaire.citation.titleBacteriaen_US
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameCoelho
person.familyNameRodrigues
person.givenNamePatricia
person.givenNameFrancisco
person.identifier2982790
person.identifier.ciencia-id231C-F92A-1BC2
person.identifier.ciencia-id7A18-045E-330C
person.identifier.orcid0000-0001-8405-4249
person.identifier.ridJTV-3288-2023
person.identifier.scopus-author-id57214122402
rcaap.cv.cienciaid7A18-045E-330C | Francisco José Barbas Rodrigues
rcaap.rightsopenAccessen_US
relation.isAuthorOfPublication30f36b8c-0bee-46cd-9ecf-be2a8dc33bd6
relation.isAuthorOfPublicationd496c83f-3a6b-424e-ba10-452ce609d597
relation.isAuthorOfPublication.latestForDiscoveryd496c83f-3a6b-424e-ba10-452ce609d597

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