{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:59:19Z","timestamp":1791413959332,"version":"4.3.3"},"reference-count":37,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2022,1,1]]},"abstract":"<jats:p>\n                    Antimicrobial resistance is a worldwide problem, and resistance in Enterobacteriaceae, particularly\n                    <jats:italic toggle=\"yes\">Escherichia coli<\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                    , is a critical threat to human health. Inappropriate and unnecessary use of antibiotics in human health care is the most common cause for the development and spread of antimicrobial resistance. In this work, we retrospectively analyzed the antimicrobial data of\n                    <jats:italic toggle=\"yes\">E. coli<\/jats:italic>\n                    strains isolated from midstream urinary samples over a 20-year period (2000\u20132019). The aim was to provide useful information to clinicians to prescribe a more appropriate empirical antibiotic therapy. A total of 30,955 unique\n                    <jats:italic toggle=\"yes\">E. coli<\/jats:italic>\n                    isolates from positive midstream urine samples of inpatients (1,198) and outpatients (29,757) were collected. Except for carbapenems, over time all the antibiotics tested showed increasing resistance rates in both groups (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.0001). On the other hand, fosfomycin and nitrofurantoin presented significant decreasing trends in resistance rate (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.05). There were significant increases in extended-spectrum \u03b2-lactamases- and multidrug resistance positive isolates starting in 2000 (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.0001), with similar results in both groups. Ciprofloxacin, gentamicin, trimethoprim\/sulfamethoxazole, and third-generation cephalosporin resistances significantly increased with increasing age (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.0001). Collectively,\n                    <jats:italic toggle=\"yes\">E. coli<\/jats:italic>\n                    resistance rates severely increased during the study period, except for fosfomycin and nitrofurantoin. The need of monitoring studies about antibiotic nonsusceptibilities at local and regional levels are necessary to enhance the focus on antimicrobial stewardship, to reduce antimicrobial consumption and to detect alarming resistance mechanisms.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2021.0010","type":"journal-article","created":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T16:49:01Z","timestamp":1631638141000},"page":"63-72","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":23,"title":["Antimicrobial Resistance Trends of\n                    <i>Escherichia coli<\/i>\n                    Isolates from Outpatient and Inpatient Urinary Infections over a 20-Year Period"],"prefix":"10.1177","volume":"28","author":[{"given":"Antonio","family":"Milano","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, University of Milano-Bicocca, Azienda Socio Sanitaria Territoriale di Monza ASST-Monza, Desio Hospital, Desio, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adela","family":"Sulejmani","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, University of Milano-Bicocca, Azienda Socio Sanitaria Territoriale di Monza ASST-Monza, Desio Hospital, Desio, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0978-9573","authenticated-orcid":false,"given":"Jari","family":"Intra","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, University of Milano-Bicocca, Azienda Socio Sanitaria Territoriale di Monza ASST-Monza, Desio Hospital, Desio, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Roberta","family":"Sala","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, University of Milano-Bicocca, Azienda Socio Sanitaria Territoriale di Monza ASST-Monza, Desio Hospital, Desio, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerio","family":"Leoni","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, University of Milano-Bicocca, Azienda Socio Sanitaria Territoriale di Monza ASST-Monza, Desio Hospital, Desio, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Carcione","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, University of Milano-Bicocca, Azienda Socio Sanitaria Territoriale di Monza ASST-Monza, Desio Hospital, Desio, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,1,13]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.coph.2014.09.006"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2017.08.014"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.15.152710"},{"key":"e_1_3_5_5_2","first-page":"98","article-title":"Patterns of multi-drug resistant bacteria at first culture from patients admitted to a third level University hospital in Calabria from 2011 to 2014: implications for empirical therapy and infection control","volume":"25","author":"Reale M.","year":"2017","unstructured":"Reale M., , Strazzulla A., , Quirino A., et al. 2017. Patterns of multi-drug resistant bacteria at first culture from patients admitted to a third level University hospital in Calabria from 2011 to 2014: implications for empirical therapy and infection control. Infez. Med. 25:98\u2013107.","journal-title":"Infez. Med"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0924-8579(09)70550-3"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2012.09.016"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2013.09.003"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-019-03655-3"},{"key":"e_1_3_5_10_2","unstructured":"European Centre for Disease Prevention and Control. 2020. Antimicrobial resistance in the EU\/EEA (EARS-Net)-Annual Epidemiological Report 2019. 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Available at http:\/\/uroweb.org\/guidelines\/compilations-of-all-guidelines\/ (accessed December2021).","journal-title":"EAU Guidelines Office,"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1080\/00325481.2019.1680052"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.18773\/austprescr.2019.002"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.5114\/aoms.2013.39202"},{"key":"e_1_3_5_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2019.07.018"},{"key":"e_1_3_5_33_2","doi-asserted-by":"publisher","DOI":"10.33073\/pjm-2019-048"},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2013.10.008"},{"key":"e_1_3_5_35_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12941-019-0343-8"},{"key":"e_1_3_5_36_2","first-page":"1800339","article-title":"The European Survey on Transatlantic Task Force on Antimicrobial Resistance Tatfar Action Group","volume":"24","author":"Atri F.","year":"2019","unstructured":"D'Atri F., , Arthur J., , Blix H.S, et al. 2019. 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