{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T14:32:57Z","timestamp":1792765977646,"version":"4.5.0"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T00:00:00Z","timestamp":1740614400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Background<\/jats:title>\n Urinary tract infection (UTI) is the most common infection requiring empiric antibiotic treatment. Due to the increased antibiotic resistance of uropathogens and their regional variation, monitoring pathogen distribution and antimicrobial susceptibility is important to ensure effective antibiotic therapy. This retrospective study analyzed the 3-year-long uropathogen profiles and their resistance from a single tertiary general hospital (single-center) and 28 hospitals (multi-center) to provide data allowing guidance for appropriate empiric antimicrobial treatment for UTI.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A total of 26,108 non-repetitive clinical urine isolates from the single-center during 2017\u20132019 and the multi-center in 2018 were collected, the pathogen and antimicrobial resistance profiles were analyzed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Escherichia coli<\/jats:italic>\n ,\n Enterococcus faecium<\/jats:italic>\n ,\n Klebsiella pneumoniae<\/jats:italic>\n ,\n Enterococcus faecalis,<\/jats:italic>\n and\n Pseudomonas aeruginosa<\/jats:italic>\n were the top five bacterial pathogens for both the multi-center and single-center, while the proportion of\n Candida albicans<\/jats:italic>\n was higher in the single-center.\n E. coli<\/jats:italic>\n was the most resistant species, with resistance rates exceeding 50% for 13\/30 of the antibiotics tested, even exceeding 80% for ampicillin, nalidixic acid and piperacillin. Particularly, the resistance rates of\n E. coli<\/jats:italic>\n to cefazolin were 62.7% in the multi-center while exceeding 90% in the single-center. Similarly, the resistance rates of\n K. pneumoniae<\/jats:italic>\n were approximately 40%\u202f~\u202f60% to 16\/29 of the antibiotics tested in the single-center, compared to 30%\u202f~\u202f50% in the multi-center. In enterococci,\n E. faecium<\/jats:italic>\n showed the resistance rates exceeding 90% for 6\/10 of the antibiotics tested, while\n E. faecalis<\/jats:italic>\n was highly resistant to erythromycin (&gt; 66%) and tetracycline (&gt; 81%). The main fungal pathogens were\n C. albicans<\/jats:italic>\n ,\n Candida tropicalis,<\/jats:italic>\n and\n Candida glabrata<\/jats:italic>\n , with the highest resistance rates exceeding 30% for\n C. tropicalis<\/jats:italic>\n to fluconazole, itraconazole and voriconazole. The main extended-spectrum beta lactamase (ESBL)-producing isolates were\n E. coli<\/jats:italic>\n (86.3%) and\n K. pneumoniae<\/jats:italic>\n (11.3%), with resistance rates exceeding 60% for cephalosporins, sulfonamides, quinolones and tetracycline in the single-center.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Escherichia coli<\/jats:italic>\n ,\n E. faecium<\/jats:italic>\n ,\n K. pneumoniae<\/jats:italic>\n ,\n E. faecalis<\/jats:italic>\n ,\n P. aeruginosa<\/jats:italic>\n and\n C. albicans<\/jats:italic>\n were the main uropathogens in the southwestern region of China, while\n E. coli<\/jats:italic>\n and\n E. faecium<\/jats:italic>\n showed the highest antibiotic resistance. The high resistance of ESBL-producing isolates to cephalosporins, sulfonamides, quinolones and tetracycline in the tertiary general hospital suggests a greater challenge to their antibiotic administration and timely ESBL test, and the empirical antimicrobial therapy should greatly consider the updated local characteristics of the uropathogen resistance, and be more cautious in the tertiary general hospital where patients are more likely to harbor higher resistant pathogens.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1493980","type":"journal-article","created":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T10:51:47Z","timestamp":1740653507000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Uropathogen profiles and their antimicrobial resistance patterns in patients: a three-year retrospective study in Sichuan region"],"prefix":"10.3389","volume":"13","author":[{"given":"Xiaofang","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanfang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yilei","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyi","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiwei","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qun","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,27]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1387","DOI":"10.1016\/0002-9378(91)91478-F","article-title":"New directions in the diagnosis and therapy of urinary tract infections","volume":"164","author":"Powers","year":"1991","journal-title":"Am J Obstet Gynecol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1085","DOI":"10.1016\/j.urology.2007.12.091","article-title":"Urinary tract infection and inflammation at onset of interstitial cystitis\/painful bladder syndrome","volume":"71","author":"Warren","year":"2008","journal-title":"Urology"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1038\/s41585-020-0362-4","article-title":"Epidemiology, definition and treatment of complicated urinary tract infections","volume":"17","author":"Wagenlehner","year":"2020","journal-title":"Nat Rev Urol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"813145","DOI":"10.3389\/fmicb.2021.813145","article-title":"Urinary tract infection etiological profiles and antibiotic resistance patterns varied among different age categories: a retrospective study from a tertiary general hospital during a 12-year period","volume":"12","author":"Huang","year":"2021","journal-title":"Front Microbiol"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00346-20","article-title":"Antimicrobial susceptibility and cross-resistance patterns among common complicated urinary tract infections in U.S. hospitals, 2013 to 2018","volume":"64","author":"Zilberberg","year":"2020","journal-title":"Antimicrob Agents Chemother"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1097","DOI":"10.3390\/jcm10051097","article-title":"Urinary microbiome characteristics in female patients with acute uncomplicated cystitis and recurrent cystitis","volume":"10","author":"Yoo","year":"2021","journal-title":"J Clin Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1093\/clinids\/22.1.91","article-title":"Recurrence of urinary tract infection in a primary care setting: analysis of a 1-year follow-up of 179 women","volume":"22","author":"Ik\u00e4heimo","year":"1996","journal-title":"Clin Infect Dis"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1016\/S0924-8579(00)00350-2","article-title":"Recurrent urinary tract infection in women","volume":"17","author":"Hooton","year":"2001","journal-title":"Int J Antimicrob Agents"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1086\/650482","article-title":"Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 international clinical practice guidelines from the Infectious Diseases Society of America","volume":"50","author":"Hooton","year":"2010","journal-title":"Clin Infect Dis"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.urology.2019.10.018","article-title":"Multiplex PCR based urinary tract infection (UTI) analysis compared to traditional urine culture in identifying significant pathogens in symptomatic patients","volume":"136","author":"Wojno","year":"2020","journal-title":"Urology"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"965053","DOI":"10.3389\/fmicb.2022.965053","article-title":"Bacterial profile and antibiotic susceptibility pattern of uropathogens causing urinary tract infection in the eastern part of northern India","volume":"13","author":"Bhargava","year":"2022","journal-title":"Front Microbiol"},{"key":"ref12","volume-title":"EAU guidelines on urological infections","year":"2022"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1186\/s12866-022-02551-9","article-title":"Antimicrobial resistance in urinary pathogens and culture-independent detection of trimethoprim resistance in urine from patients with urinary tract infection","volume":"22","author":"Somorin","year":"2022","journal-title":"BMC Microbiol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"962","DOI":"10.1111\/1469-0691.12089","article-title":"Healthcare-associated, community-acquired and hospital-acquired bacteraemic urinary tract infections in hospitalized patients: a prospective multicentre cohort study in the era of antimicrobial resistance","volume":"19","author":"Horcajada","year":"2013","journal-title":"Clin Microbiol Infect"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"691210","DOI":"10.3389\/fcimb.2021.691210","article-title":"Recurrent urinary tract infection: a mystery in search of better model systems","volume":"11","author":"Murray","year":"2021","journal-title":"Front Cell Infect Microbiol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"654","DOI":"10.1186\/s12879-017-2743-8","article-title":"Species distribution and antibiotic susceptibility profile of bacterial uropathogens among patients complaining urinary tract infections","volume":"17","author":"Bitew","year":"2017","journal-title":"BMC Infect Dis"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1007\/5584_2020_566","article-title":"The role of gram-negative Bacteria in urinary tract infections: current concepts and therapeutic options","volume":"1323","author":"Behzadi","year":"2021","journal-title":"Adv Exp Med Biol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"53","DOI":"10.12138\/j.issn.1671-9638.20216181","article-title":"Antimicrobial resistance of bacteria from urine specimens: surveillance report from China antimicrobial resistance surveillance system in 2014-2019","volume":"20","year":"2021","journal-title":"Chin J Infect Control"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"982","DOI":"10.1007\/s00467-004-1528-7","article-title":"Antibiotic resistance of urinary tract pathogens and rationale for empirical intravenous therapy","volume":"19","author":"Haller","year":"2004","journal-title":"Pediatr Nephrol"},{"key":"ref20","volume-title":"Performance standards for antimicrobial susceptibility testing","year":"2018"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"912","DOI":"10.13461\/j.cnki.cja.006988","article-title":"Distribution and drug resistance of pathogens isolated from patients with urinary tract infections according to Sichuan provincial antimicrobial resistant investigation net in 2018","volume":"45","author":"Feng","year":"2020","journal-title":"Chin J Antibiot"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2022\/3512582","article-title":"Analysis of the distribution and antibiotic resistance of pathogens causing infections in hospitals from 2017 to 2019","volume":"2022","author":"Liu","year":"2022","journal-title":"Evid Based Complement Alternat Med"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1186\/s12879-019-4724-6","article-title":"Effect of prior receipt of antibiotics on the pathogen distribution: a retrospective observational cohort study on 27, 792 patients","volume":"20","author":"Li","year":"2020","journal-title":"BMC Infect Dis"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"6413","DOI":"10.2147\/IDR.S384515","article-title":"Analysis of the distribution and drug resistance of pathogens in patients with urinary tract infection in the eastern Chongming area of Shanghai from 2018 to 2020","volume":"15","author":"Li","year":"2022","journal-title":"Infect Drug Resist"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1066","DOI":"10.11816\/cn.ni.2020-191204","article-title":"Distribution and drug resistance of bacteria in urine samples of Sichuan bacterial resistance monitoring network from 2015 to 2018","volume":"30","author":"Long","year":"2020","journal-title":"Chin J Nosocomiol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"3019","DOI":"10.3969\/j.issn.1673-4130.2014.22.006","article-title":"Distribution and drug resistance of pathogen isolated from patients with urinary tract infection according to Sichuan provincial antimicrobial resistant investigation net during 2011-2012","volume":"35","author":"Yin","year":"2014","journal-title":"Int J Laborat Med"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2021\/6646024","article-title":"Urine culture in hospitalized patients during 2014-2018: an analysis on pathogen distribution and drug sensitivity","volume":"2021","author":"Sun","year":"2021","journal-title":"Dis Markers"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1327","DOI":"10.3969\/j.issn.1009-5519.2019.09.015","article-title":"Analysis of the pathogens and drug resistance change in urinary tract infection in 10 years","volume":"35","author":"He","year":"2019","journal-title":"J Mod Med Health"},{"key":"ref29","first-page":"1617","article-title":"The identification results and analysis of drug resistance of 5049 urine microbial culture","volume":"25","author":"Wu","year":"2021","journal-title":"Chin J Laborat Diagnost"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"158","DOI":"10.3969\/j.issn.1672-7193.2021.02.016","article-title":"Analysis of pathogen distribution and drug resistance in the urology department of a hospital from 2017 to 2019","volume":"23","author":"Yang","year":"2021","journal-title":"J Milit Surg Southwest China"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"826","DOI":"10.13493\/j.issn.1672-7878.2022.06-014","article-title":"Detection of pathogens and drug sensitivity of hospitalized patients in a hospital from 2017 to 2021","volume":"19","author":"Liu","year":"2022","journal-title":"Antiinfect Phar"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"e00577\u201318","DOI":"10.1128\/JCM.00577-18","article-title":"Five-year National Surveillance of invasive candidiasis: species distribution and azole susceptibility from the China hospital invasive fungal surveillance net (CHIF-NET) study","volume":"56","author":"Xiao","year":"2018","journal-title":"J Clin Microbiol"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"S139","DOI":"10.1093\/infdis\/jiz573","article-title":"Distribution and antifungal susceptibility of Candida species causing Candidemia in China: an update from the CHIF-NET study","volume":"221","author":"Xiao","year":"2020","journal-title":"J Infect Dis"},{"key":"ref34","first-page":"890","article-title":"Differences of distribution and drug resistance of pathogens in urinary tract infections between male and female","volume":"44","author":"Liang","year":"2017","journal-title":"Modern Prevent Med"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1016\/j.jgar.2019.07.019","article-title":"Uropathogens and antibiotic resistance in the community and hospital-induced urinary tract infected children","volume":"20","author":"Demir","year":"2020","journal-title":"J Glob Antimicrob Resist"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1053","DOI":"10.13461\/j.cnki.cja.007021","article-title":"Distribution and change of drug resistance profile of pathogens causing urinary tract infection in a tumor hospital in Zhejiang province 2014-2019","volume":"45","author":"Zhang","year":"2020","journal-title":"Chin J Antibiot"},{"key":"ref37","first-page":"63","article-title":"Analysis on the composition and drug resistance of pathogenic bacteria causing catheter-associated urinary tract infections in Harbin","volume":"12","author":"Xia","year":"2022","journal-title":"China Med Pharm"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"139","DOI":"10.3969\/j.issn.1007-614x.2020.05.088","article-title":"Distribution and drug resistance of pathogens in patients with urinary tract infection","volume":"36","author":"Liu","year":"2020","journal-title":"Chin Comm Doct"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"e107453","DOI":"10.5812\/jjm.107453","article-title":"Epidemiology and antimicrobial susceptibility pattern of Uropathogens in patients with the community-and hospital-acquired urinary tract infections at a tertiary Hospital in Somalia","volume":"13","author":"Mohamed","year":"2020","journal-title":"Jundishapur J Microbiol"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"1053","DOI":"10.3870\/j.issn.1004-0781.2021.08.012","article-title":"Distribution of pathogenic bacteria and drug resistance analysis of bloodstream infections in Sichuan Province bacterial drug resistance monitoring network from 2016 to 2020","volume":"40","author":"Long","year":"2021","journal-title":"Herald Med"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"688","DOI":"10.12182\/20220760506","article-title":"Changes and trends of drug resistance of pathogenic Bacteria in blood samples of a tertiary-level teaching hospital from 2016 to 2020","volume":"53","author":"Deng","year":"2022","journal-title":"J. Sichuan Univ."},{"key":"ref42","doi-asserted-by":"publisher","first-page":"338-44+49","DOI":"10.13515\/j.cnki.hnjpm.1006-8414.2023.05.022","article-title":"Distribution of pathogenic bacteria and change of drug resistance in bloodstream infections in a tertiary hospital in Henan Province from 2013 to 2021","volume":"34","author":"Sun","year":"2023","journal-title":"Modern Dis Prev Control"},{"key":"ref43","first-page":"51","article-title":"Analysis of the use of anti-infective drugs in Zhengzhou maternal and child health hospital from 1997 to 1998","volume":"8","author":"Yang","year":"2000","journal-title":"Henan Med Informat"},{"key":"ref44","first-page":"53","article-title":"Dynamic analysis of antimicrobial drug use in Weifang People's hospital from 1997 to 1999","volume":"20","author":"Wang","year":"2001","journal-title":"Shandong Pharmaceut Industry"},{"key":"ref45","first-page":"86","article-title":"Hospitalization costs and antimicrobial drug use in 1515 discharged medical records","volume":"10","author":"Zhou","year":"2001","journal-title":"Chin J Pharmacoepidemiol"},{"key":"ref46","first-page":"954","article-title":"Analysis of utilization and cost of antimicrobial drugs in outpatient prescriptions of our hospital in 2000","volume":"23","author":"Jiang","year":"2001","journal-title":"Guangxi Med J"},{"key":"ref47","first-page":"206","article-title":"Selection of antimicrobial drugs for urinary tract infections and their evaluation","volume":"21","author":"Yin","year":"2001","journal-title":"Chin J Pract Internal Med"},{"key":"ref48","first-page":"188","article-title":"Veterinary antimicrobial resistance management in international organizations","volume":"37","author":"Zhang","year":"2010","journal-title":"China Anim Husb Veter Med"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"80","DOI":"10.11751\/ISSN.1002-1280.2019.05.11","article-title":"Investigation and analysis of the use of veterinary antimicrobial drugs in China","volume":"53","author":"Wang","year":"2019","journal-title":"Chin J Veterin Med"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"62","DOI":"10.3969\/j.issn.1005-944X.2018.04.017","article-title":"Global usage of veterinary antimicrobial agents","volume":"35","author":"Wang","year":"2018","journal-title":"China Anim Health Inspect"},{"key":"ref51","volume-title":"Drafting notes for the guidelines for the clinical use of antimicrobials","year":"2004"},{"key":"ref52","volume-title":"Clinical application of antimicrobial drugs and establishment of bacterial resistance monitoring network","year":"2005"},{"key":"ref53","first-page":"54","article-title":"Domestic current status of veterinary antibacterial agent usage and discussion of antibacterial-free raise","volume":"47","author":"Gu","year":"2013","journal-title":"Chin J Vet Med"},{"key":"ref54","volume-title":"Determination of erythromycin residues in aquatic products by liquid chromatography-tandem mass spectrometry: GB 29684-2013. Beijing: Standards Press of China","year":""},{"key":"ref55","volume-title":"The Ministry of Agriculture launched the national five-year action on comprehensive treatment of veterinary drugs (antimicrobials)","author":"Chen","year":"2015"},{"key":"ref56","volume-title":"Notice of the general Office of the Ministry of agriculture and rural affairs on the pilot work of the action to reduce the use of veterinary antimicrobials","year":"2018"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"116","DOI":"10.19739\/j.cnki.issn1001-9510.2021.02.009","article-title":"Distribution and drug resistance of pathogenic bacteria in urinary tract infection in a hospital from 2014 to 2019","volume":"44","author":"Dong","year":"2021","journal-title":"J Binzhou Med Univ"},{"key":"ref58","first-page":"190","article-title":"Pathogens identified in urine culture and drug-resistance monitoring","volume":"11","author":"Liang","year":"2012","journal-title":"J Clin Experiment Med"},{"key":"ref59","first-page":"38","article-title":"Pathogens from 1151 cases of urine culture and their antibiotic resistance profile","volume":"15","author":"Cai","year":"2015","journal-title":"Chin J Infect Chemother"},{"key":"ref60","first-page":"1017","article-title":"Distribution and drug resistance of pathogens isolated from urine samples of patients with suspected urinary tract infection during 2016-2020","volume":"32","author":"Dong","year":"2022","journal-title":"Chin J Health Lab Technol"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1493980\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T10:52:13Z","timestamp":1740653533000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1493980\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,27]]},"references-count":60,"alternative-id":["10.3389\/fpubh.2025.1493980"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1493980","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,27]]},"article-number":"1493980"}}