{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T03:52:25Z","timestamp":1789617145425,"version":"build-2803163510"},"reference-count":18,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"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":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Antimicrobial resistance is a critical global threat in resource-limited settings with underdeveloped laboratory capacity and stewardship programs. Intensive care unit (ICU) patients are at high risk for complicated urinary tract infections (cUTIs) caused by multidrug-resistant (MDR) uropathogens. Local resistance data are essential to guide empirical therapy and design effective stewardship interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective, cross-sectional study (March 2020\u2013December 2022) of 127 adult ICU patients with cUTIs at a tertiary hospital in Tehran, Iran. Urine isolates were identified by standard phenotypic methods, and antimicrobial susceptibility testing (AST) was performed via disk diffusion following Clinical and Laboratory Standards Institute guidelines. Resistance phenotypes\u2014extended-spectrum beta-lactamase (ESBL) production, carbapenem-resistant Enterobacteriaceae, vancomycin-resistant enterococci (VRE), difficult-to-treat\n                      <jats:italic toggle=\"yes\">Pseudomonas<\/jats:italic>\n                      , and pan-drug-resistant (PDR)\n                      <jats:italic toggle=\"yes\">Acinetobacter baumannii<\/jats:italic>\n                      \u2014were defined using current breakpoints.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Escherichia coli<\/jats:italic>\n                      (52.2%) and\n                      <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                      (26.9%) predominated. Among Enterobacterales, 60.4% produced ESBL and 30.2% were carbapenem resistant. VRE comprised all enterococcal isolates; PDR\n                      <jats:italic toggle=\"yes\">A. baumannii<\/jats:italic>\n                      occurred in one case. No significant associations were found between resistance profiles and sepsis, septic shock, or mortality. Multivariable analysis identified heart failure (odds ratio [OR] 2.45; 95% confidence interval [CI] 1.15\u20135.21;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.017) and longer ICU stay (OR 1.03 per day; 95% CI 1.01\u20131.05;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.012) as independent predictors of MDR infection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>We report an alarming burden of MDR uropathogens in Tehran ICUs, underscoring the need for tailored empirical-therapy guidelines, enhanced antimicrobial stewardship programs, and multicenter surveillance to curb resistance and improve patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10766294251384089","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:59:33Z","timestamp":1759193973000},"page":"345-353","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Prevalence and Resistance Patterns of Uropathogens in Critically Ill Patients at a Tertiary Care Hospital in Tehran: Implications for Antimicrobial Stewardship in Developing Countries"],"prefix":"10.1177","volume":"31","author":[{"given":"Parisa","family":"Kianpour","sequence":"first","affiliation":[{"name":"Anesthesia, Critical Care and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saba","family":"Ranjbarian","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faezeh","family":"Azimi Movahed","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sepideh","family":"Hamedi","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Mourtami","sequence":"additional","affiliation":[{"name":"Anesthesia, Critical Care and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran."},{"name":"School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammadamin","family":"Qahari","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pejman","family":"Pourfakhr","sequence":"additional","affiliation":[{"name":"Anesthesia, Critical Care and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamidreza","family":"Sharifnia","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical care, School of Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mojtaba","family":"Mojtahedzadeh","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farhad","family":"Najmeddin","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"key":"e_1_3_6_2_2","unstructured":"World Health Organization. Antimicrobial resistance. [Internet]. 2023 [cited 2025 Jun 29]. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/antimicrobial-resistance"},{"key":"e_1_3_6_3_2","unstructured":"World Health Organization. Global antimicrobial resistance and use surveillance system (GLASS) report: 2022. [Internet]. 2022 [cited 2025 Jun 29]. Available from: https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC10843100\/"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-023-01254-8"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.12669\/pjms.41.3.10392"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/mdr.2020.0130"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-53596-x"},{"key":"e_1_3_6_8_2","unstructured":"Centers for Disease Control and Prevention. Urinary tract infection (Catheter-associated urinary tract infection [CAUTI] and non-catheter-associated urinary tract infection [UTI]) events [Internet]. Atlanta GA: CDC; January 2024 [cited 2025 Jul 13]. Available from: https:\/\/www.cdc.gov\/nhsn\/pdfs\/pscmanual\/7psccauticurrent.pdf"},{"key":"e_1_3_6_9_2","unstructured":"The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 12.0 2022. Available from: http:\/\/www.eucast.org"},{"key":"e_1_3_6_10_2","volume-title":"CLSI supplement M100","author":"Clinical and Laboratory Standards Institute (CLSI)","year":"2021","unstructured":"Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing. 31st ed. CLSI supplement M100. Wayne, PA: CLSI; 2021.","edition":"31"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-024-01497-z"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.3389\/frabi.2023.1177954"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2024.107321"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","unstructured":"Iqbal F Alocious A Joy S Stanly E Rajesh V Unnikrishnan M et al. Vancomycin-resistant enterococci: A rising challenge to global health. Clin Epidemiol Glob Health. 2024;28:101663; doi: 10.1016\/j.cegh.2024.101663","DOI":"10.1016\/j.cegh.2024.101663"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.3390\/jof11040258"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-020-00751-4"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms13020440"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.30699\/IJP.2023.1990807.3073"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-023-01343-8"}],"container-title":["Microbial Drug Resistance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10766294251384089","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10766294251384089","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10766294251384089","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T01:20:35Z","timestamp":1777684835000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.1177\/10766294251384089"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":18,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1177\/10766294251384089"],"URL":"https:\/\/doi.org\/10.1177\/10766294251384089","relation":{},"ISSN":["1076-6294","1931-8448"],"issn-type":[{"value":"1076-6294","type":"print"},{"value":"1931-8448","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]}}}