{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:55:08Z","timestamp":1792788908463,"version":"4.5.0"},"reference-count":48,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the European Union\u2019s Next Generation EU through the National Recovery"},{"name":"Resilience Plan of the Republic of Bulgaria"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: Urinary tract infections (UTIs) are among the most common hospital- and community-acquired infections, creating a substantial healthcare burden due to recurrence, complications, and rising antimicrobial resistance. Accurate diagnosis and timely antimicrobial therapy are essential. This study aimed to identify trends in the etiology, treatment, and resistance patterns of UTIs through a retrospective analysis of urine isolates processed at the Laboratory of Microbiology at University Hospital St. George in Plovdiv, the largest tertiary care and reference microbiology center in Bulgaria, between 2017 and 2022. Materials and Methods: A retrospective single-center study was performed at the hospital\u2019s Microbiology Laboratory. During the study period, 74,417 urine samples from 25,087 hospitalized patients were screened with the HB&amp;L UROQUATTRO system. Positive specimens were cultured on blood agar, Eosin-Methylene Blue, and chromogenic media. Identification was performed using biochemical assays, MALDI-TOF MS, and the Vitek 2 Compact system. Antimicrobial susceptibility testing included disk diffusion, MIC determination, broth microdilution (for colistin), and Vitek 2 Compact, interpreted according to EUCAST standards. Descriptive analysis and temporal resistance trends were evaluated with regression models, and interrupted time-series analysis was applied to assess COVID-19-related effects. Results: Out of 10,177 isolates, Gram-negative bacteria predominated (73%), with Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis as the leading pathogens. Among Gram-positives, Enterococcus faecalis was the most frequent. In the post-COVID-19 period, ESBL production increased in E. coli (34\u201338%), K. pneumoniae (66\u201377%), and P. mirabilis (13.5\u201324%). Carbapenem resistance rose in K. pneumoniae (to 40.6%) and P. aeruginosa (to 24%), while none was detected in E. coli. Colistin resistance increased in K. pneumoniae but remained absent in E. coli and P. aeruginosa. High-level aminoglycoside resistance in E. faecalis was stable (~70%), and vancomycin resistance in E. faecium rose from 4.6% to 8.9%. Conclusions: Both community- and hospital-acquired UTIs in Southeastern Bulgaria are increasingly linked to multidrug-resistant pathogens, particularly ESBL-producing and carbapenem-resistant Enterobacterales. Findings from the region\u2019s largest referral center highlight the urgent need for continuous surveillance, rational antibiotic use, and novel therapeutic approaches.<\/jats:p>","DOI":"10.3390\/antibiotics14100982","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T16:43:54Z","timestamp":1759250634000},"page":"982","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Urinary Tract Infections in a Single-Center Bulgarian Hospital: Trends in Etiology, Antibiotic Resistance, and the Impact of the COVID-19 Pandemic (2017\u20132022)"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7045-5447","authenticated-orcid":false,"given":"Milena Yancheva","family":"Rupcheva","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology and Immunology \u201cProf. Dr. Elissay Yanev\u201d, Faculty of Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria"},{"name":"Research Institute at Medical University\u2014Plovdiv (RIMU), 4002 Plovdiv, Bulgaria"},{"name":"Laboratory of Microbiology, University Hospital St. George, 4002 Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1414-8738","authenticated-orcid":false,"given":"Kostadin","family":"Kostadinov","sequence":"additional","affiliation":[{"name":"Research Institute at Medical University\u2014Plovdiv (RIMU), 4002 Plovdiv, Bulgaria"},{"name":"Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8062-6799","authenticated-orcid":false,"given":"Yordan","family":"Kalchev","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Immunology \u201cProf. Dr. Elissay Yanev\u201d, Faculty of Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria"},{"name":"Research Institute at Medical University\u2014Plovdiv (RIMU), 4002 Plovdiv, Bulgaria"},{"name":"Laboratory of Microbiology, University Hospital St. George, 4002 Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6862-1135","authenticated-orcid":false,"given":"Petya","family":"Gardzheva","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Immunology \u201cProf. Dr. Elissay Yanev\u201d, Faculty of Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria"},{"name":"Research Institute at Medical University\u2014Plovdiv (RIMU), 4002 Plovdiv, Bulgaria"},{"name":"Laboratory of Microbiology, University Hospital St. George, 4002 Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1074-7709","authenticated-orcid":false,"given":"Eli","family":"Hristozova","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Immunology \u201cProf. Dr. Elissay Yanev\u201d, Faculty of Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria"},{"name":"Research Institute at Medical University\u2014Plovdiv (RIMU), 4002 Plovdiv, Bulgaria"},{"name":"Laboratory of Microbiology, University Hospital St. George, 4002 Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2160-7648","authenticated-orcid":false,"given":"Zoya","family":"Rachkovska","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Immunology \u201cProf. Dr. Elissay Yanev\u201d, Faculty of Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria"},{"name":"Laboratory of Microbiology, University Hospital St. George, 4002 Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0997-1439","authenticated-orcid":false,"given":"Gergana","family":"Lengerova","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Immunology \u201cProf. Dr. Elissay Yanev\u201d, Faculty of Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria"},{"name":"Research Institute at Medical University\u2014Plovdiv (RIMU), 4002 Plovdiv, Bulgaria"},{"name":"Laboratory of Microbiology, University Hospital St. George, 4002 Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1430-9848","authenticated-orcid":false,"given":"Andreana","family":"Angelova","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Immunology \u201cProf. Dr. Elissay Yanev\u201d, Faculty of Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria"},{"name":"Research Institute at Medical University\u2014Plovdiv (RIMU), 4002 Plovdiv, Bulgaria"},{"name":"Laboratory of Microbiology, University Hospital St. George, 4002 Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1357-6717","authenticated-orcid":false,"given":"Marianna","family":"Murdjeva","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Immunology \u201cProf. Dr. Elissay Yanev\u201d, Faculty of Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria"},{"name":"Research Institute at Medical University\u2014Plovdiv (RIMU), 4002 Plovdiv, Bulgaria"},{"name":"Laboratory of Microbiology, University Hospital St. George, 4002 Plovdiv, Bulgaria"},{"name":"Department of Microbiology and Virology, Faculty of Pharmacy, Medical University of Pleven, 5800 Pleven, Bulgaria"},{"name":"Institute for Innovation and Smart Technology (IIST), University of Telecommunication and Posts, 1700 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6214-3408","authenticated-orcid":false,"given":"Michael M.","family":"Petrov","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Immunology \u201cProf. Dr. Elissay Yanev\u201d, Faculty of Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria"},{"name":"Research Institute at Medical University\u2014Plovdiv (RIMU), 4002 Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Mititelu, M., Olteanu, G., Neac\u0219u, S.M., Stoicescu, I., Dumitrescu, D.-E., Gheorghe, E., Tarcea, M., Busnatu, \u0218.S., Ioni\u021b\u0103-M\u00eendrican, C.-B., and Tafuni, O. (2024). Incidence of Urinary Infections and Behavioral Risk Factors. Nutrients, 16.","DOI":"10.3390\/nu16030446"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Anton, C.-I., \u0218tefan, I., Zamfir, M., Ghia\u021b\u0103u, C.F., Sima, C.S., Osman, C.L., \u0218tefan, T.A., and Streinu-Cercel, A. (2025). Etiology and Risk Factors of Recurrent Urinary Tract Infections in Women in a Multidisciplinary Hospital in Romania. Microorganisms, 13.","DOI":"10.3390\/microorganisms13030626"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Turcu, F.L., Vacaroiu, I.A., Balcangiu-Stroescu, A.E., Mitrea, A.R., Miricescu, D., Balan, D.G., and Stanigut, A.M. (2025). Recurrent Urinary Tract Infections in Female Patients\u2014A Clinical Review. J. Mind Med. Sci., 12.","DOI":"10.3390\/jmms12010005"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1038\/nrurol.2010.190","article-title":"The Epidemiology of Urinary Tract Infection","volume":"7","author":"Foxman","year":"2010","journal-title":"Nat. Rev. Urol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2669","DOI":"10.1007\/s00345-019-03071-4","article-title":"Epidemiology of Urological Infections: A Global Burden","volume":"38","author":"Murt","year":"2020","journal-title":"World J. Urol."},{"key":"ref_6","first-page":"64","article-title":"Epidemiological Trends of Urinary Tract Infections, Urolithiasis and Benign Prostatic Hyperplasia in 203 Countries and Territories from 1990 to 2019","volume":"8","author":"Zhu","year":"2021","journal-title":"Mil. Med. Res."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Lodise, T.P., Nowak, M., and Rodriguez, M. (2022). The 30-Day Economic Burden of Newly Diagnosed Complicated Urinary Tract Infections in Medicare Fee-for-Service Patients Who Resided in the Community. Antibiotics, 11.","DOI":"10.3390\/antibiotics11050578"},{"key":"ref_8","unstructured":"Sabih, A., and Leslie, S.W. (2022). Complicated Urinary Tract Infections. StatPearls [Internet], StatPearls Publishing."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.ijantimicag.2011.09.007","article-title":"Urosepsis\u2014From the View of the Urologist","volume":"38","author":"Wagenlehner","year":"2011","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"175628721983217","DOI":"10.1177\/1756287219832172","article-title":"An Introduction to the Epidemiology and Burden of Urinary Tract Infections","volume":"11","author":"Medina","year":"2019","journal-title":"Ther. Adv. Urol."},{"key":"ref_11","doi-asserted-by":"crossref","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":"ref_12","unstructured":"(2023, February 19). Cystitis\u2014PubMed, Available online: https:\/\/pubmed.ncbi.nlm.nih.gov\/29494042\/."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1086\/519268","article-title":"Population-Based Epidemiologic Analysis of Acute Pyelonephritis","volume":"45","author":"Czaja","year":"2007","journal-title":"Clin. Infect. Dis."},{"key":"ref_14","unstructured":"Bulgarian Association of Microbiologists (2023). Urinary Tract Infections, Bulgarian Association of Microbiologists. Available online: https:\/\/www.bam-bg.net\/images\/documents\/GoodPractices\/12.Infections_urinary.pdf."},{"key":"ref_15","unstructured":"Bono, M.J., Leslie, S.W., and Reygaert, W.C. (2022). Urinary Tract Infection. StatPearls [Internet], StatPearls Publishing."},{"key":"ref_16","unstructured":"Bonkat, G., Bartoletti, R., Bruy\u00e8re, F., Cai, T., Geerlings, S.E., K\u00f6ves, B., Schubert, S., Pilatz, A., Veeratterapillay, R., and Wagenlehner, F. (2022). EAU Guidelines on Urological Infections, European Association of Urology."},{"key":"ref_17","unstructured":"Public Health England (2025, August 25). Diagnosis of Urinary Tract Infections: Quick Reference Tool for Primary Care. Published February 2020; Last Updated 7 July 2025, Available online: https:\/\/www.gov.uk\/government\/publications\/urinary-tract-infection-diagnosis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1001\/jama.2014.303","article-title":"Urinary Tract Infections in Older Women: A Clinical Review American Medical Association","volume":"311","author":"Mody","year":"2014","journal-title":"JAMA"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"G\u00f3mez-Quiroz, A., Avila-Cardenas, B.B., De Arcos-Jim\u00e9nez, J.C., Perales-Guerrero, L., Mart\u00ednez-Ayala, P., and Briseno-Ramirez, J. (2025). The Clinical Implications of Inappropriate Therapy in Community-Onset Urinary Tract Infections and the Development of a Bayesian Hierarchical Weighted-Incidence Syndromic Combination Antibiogram. Antibiotics, 14.","DOI":"10.20944\/preprints202501.0905.v1"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Kosherova, Z., Zhazykhbayeva, D., Aimurziyeva, A., Bayesheva, D., and Semenova, Y. (2025). The Implementation of Antimicrobial Consumption Surveillance and Stewardship in Human Healthcare in Post-Soviet States: A Systematic Review. Antibiotics, 14.","DOI":"10.3390\/antibiotics14080749"},{"key":"ref_21","unstructured":"World Health Organization (2025, August 18). Antimicrobial Resistance\u2014Fact Sheet. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/antimicrobial-resistance."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e00181-19","DOI":"10.1128\/CMR.00181-19","article-title":"Antimicrobial Resistance in ESKAPE Pathogens","volume":"33","author":"Forde","year":"2020","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1086\/595011","article-title":"Bad Bugs, No Drugs: No ESKAPE! An Update from the Infectious Diseases Society of America","volume":"48","author":"Boucher","year":"2009","journal-title":"Clin. Infect. Dis."},{"key":"ref_24","unstructured":"World Health Organization (2024). WHO Bacterial Priority Pathogens List, 2024: Bacterial Pathogens of Public Health Importance to Guide Research, Development and Strategies to Prevent and Control Antimicrobial Resistance, 2024, WHO."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1038\/nrmicro3432","article-title":"Urinary Tract Infections: Epidemiology, Mechanisms of Infection and Treatment Options","volume":"13","author":"Walker","year":"2015","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Grifoni, C., Coppi, M., Baccani, I., Antonelli, A., Bevilacqua, L., Brambilla, L., Arena, F., Pupillo, R., and Rossolini, G.M. (2025). Dealing with Challenges Posed by Antimicrobial Resistance in Long-Term Acute-Care Rehabilitation Facilities. Antibiotics, 14.","DOI":"10.3390\/antibiotics14020147"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Sturza, F., Gu\u021b\u0103, \u0218.-D., and Popescu, G.-A. (2023). Antibiotics Used for COVID-19 In-Patients from an Infectious Disease Ward. Antibiotics, 12.","DOI":"10.3390\/antibiotics12010150"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Granata, G., Schiavone, F., Pipitone, G., Taglietti, F., and Petrosillo, N. (2022). Antibiotics Use in COVID-19 Patients: A Systematic Literature Review. J. Clin. Med., 11.","DOI":"10.3390\/jcm11237207"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Li, X., Fan, H., Zi, H., Hu, H., Li, B., Huang, J., Luo, P., and Zeng, X. (2022). Global and Regional Burden of Bacterial Antimicrobial Resistance in Urinary Tract Infections in 2019. J. Clin. Med., 11.","DOI":"10.3390\/jcm11102817"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Smit, C.C.H., Keighley, C., Rogers, K., Miyakis, S., Taxis, K., Sanderson-Smith, M., Nicholas, N., Robertson, H., and Pont, L.G. (2025). Geo-Temporal Variation in the Antimicrobial Resistance of Escherichia coli in the Community. Antibiotics, 14.","DOI":"10.3390\/antibiotics14030233"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Chatzidimitriou, M., Tsolakidou, P., Kyriazidi, M.A., Varlamis, S., Frydas, I.S., Mavridou, M., and Mitka, S. (2025). Report of High-Risk Carbapenem-Resistant K. pneumoniae ST307 Clone Producing KPC-2, SHV-106, CTX-M-15, and VEB-1 in Greece. Antibiotics, 14.","DOI":"10.3390\/antibiotics14060567"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3810\/pgm.2010.11.2217","article-title":"Management of Complicated Urinary Tract Infections in the Era of Antimicrobial Resistance","volume":"122","author":"Bader","year":"2010","journal-title":"Postgrad. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1053\/jhin.2000.0860","article-title":"An Outbreak of Pseudomonas aeruginosa Infection Associated with Contaminated Urodynamic Equipment","volume":"47","author":"Yardy","year":"2001","journal-title":"J. Hosp. Infect."},{"key":"ref_34","unstructured":"European Centre for Disease Prevention and Control (2025, September 17). Antimicrobial Resistance Surveillance in Europe 2023\u20132021 Data. Stockholm: ECDC; 2023. Available online: https:\/\/www.ecdc.europa.eu\/en\/publications-data\/antimicrobial-resistance-surveillance-europe-2023-2021-data."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1080\/00325481.2017.1246055","article-title":"An Update on the Management of Urinary Tract Infections in the Era of Antimicrobial Resistance","volume":"129","author":"Bader","year":"2017","journal-title":"Postgrad. Med."},{"key":"ref_36","first-page":"21","article-title":"Extensively Drug Resistant Klebsiella pneumoniae spp. pneumoniae in Patients with an Acute Urinary Tract Infection","volume":"29","author":"Grigorov","year":"2023","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/cid\/civ933","article-title":"Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America","volume":"62","author":"Pappas","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1016\/j.eururo.2008.05.010","article-title":"Surveillance Study in Europe and Brazil on Clinical Aspects and Antimicrobial Resistance Epidemiology in Females with Cystitis (ARESC): Implications for Empiric Therapy","volume":"54","author":"Naber","year":"2008","journal-title":"Eur. Urol."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Xu, X., Wang, Y., Li, N., Jin, Y., Xu, X., Zhou, Z., Xie, Y., and Sun, Q. (2025). Uropathogen Profiles and Their Antimicrobial Resistance Patterns in Patients: A Three-Year Retrospective Study in Sichuan Region. Front. Public Health, 13.","DOI":"10.3389\/fpubh.2025.1493980"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Salm, J., Salm, F., Arendarski, P., and Kramer, T.S. (2023). High Frequency of Enterococcus faecalis Detected in Urinary Tract Infections in Male Outpatients\u2014A Retrospective, Multicenter Analysis, Germany 2015 to 2020. BMC Infect. Dis., 23.","DOI":"10.1186\/s12879-023-08824-6"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Zaheer, R., Cook, S.R., Barbieri, R., Goji, N., Cameron, A., Petkau, A., Polo, R.O., Tymensen, L., Stamm, C., and Song, J. (2020). Surveillance of Enterococcus spp. Reveals Distinct Species and Antimicrobial Resistance Diversity across a One-Health Continuum. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-61002-5"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Filev, R., Bogov, B., Lyubomirova, M., and Rostaing, L. (2025). From pandemic to resistance: Addressing multidrug-resistant urinary tract infections in the Balkans. Antibiotics, 14.","DOI":"10.3390\/antibiotics14090849"},{"key":"ref_43","unstructured":"Bonkat, G., Kranz, J., Cai, T., Geerlings, S.E., K\u00f6ves, B., Pilatz, A., Medina-Polo, J., Schneidewind, L., Schubert, S., and Veeratterapillay, R. (2025, September 28). European Association of Urology Guidelines on Urological Infections. Available online: https:\/\/d56bochluxqnz.cloudfront.net\/documents\/full-guideline\/EAU-Guidelines-on-Urological-infections-2025_2025-05-24-110339_pxmf.pdf."},{"key":"ref_44","first-page":"2","article-title":"Beta Regression in R","volume":"34","author":"Zeileis","year":"2010","journal-title":"J. Stat. Softw."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Kosmidis, I., and Zeileis, A. (2025). Extended-Support Beta Regression for [0, 1] Responses. arXiv.","DOI":"10.1093\/jrsssc\/qlaf039"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"h2750","DOI":"10.1136\/bmj.h2750","article-title":"Regression-Based Quasi-Experimental Approach When Randomisation Is Not an Option: Interrupted Time Series Analysis","volume":"350","author":"Kontopantelis","year":"2015","journal-title":"BMJ"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1093\/aje\/kwae440","article-title":"Correction Re: Simple Sensitivity Analysis for Differential Measurement Error","volume":"194","author":"VanderWeele","year":"2025","journal-title":"Am. J. Epidemiol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/j.2517-6161.1995.tb02031.x","article-title":"Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing","volume":"57","author":"Benjamini","year":"1995","journal-title":"J. R. Stat. Soc. Ser. B"}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/14\/10\/982\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T16:49:41Z","timestamp":1759250981000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/14\/10\/982"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,30]]},"references-count":48,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["antibiotics14100982"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics14100982","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,30]]}}}