{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T22:55:46Z","timestamp":1793228146329,"version":"4.5.0"},"reference-count":29,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T00:00:00Z","timestamp":1740787200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Background\/Objectives: Urinary tract infections (UTI) represent a global problem with implications for mortality and morbidity. Published data present different bacterial incidences and different antibiotic resistance. The objective of our study is to evaluate the bacteria distribution in positive urine cultures in a mixed adult population and evaluate the differences in antibiotic resistance in in- and outpatients. Methods: We analyzed 1186 positive urine cultures in 2021 from the Emergency County Hospital \u201cPius Brinzeu\u201d from Timisoara, Romania. We evaluated the bacteria distribution and antibiotic resistance stratified by in and outpatients from a mixed adult population. Results: The median age was 67, with 65.7% females and 28.5% were outpatients. In inpatients, the most commonly identified bacteria was E. coli, followed by Enterococcus spp., and Klebsiella spp., while in outpatients, E. coli, Enterococcus spp., and Klebsiella spp. were the leading ones. Overall, E. coli presented the highest resistance rate to ampicillin, Enterococcus spp. to ciprofloxacin, Klebsiella spp. to cephalosporins, and Proteus spp. to trimethoprim\/sulfamethoxazole. Inpatients presented higher resistance rates for E. coli to ceftazidime, cefuroxime, gentamycin, ciprofloxacin, and trimethoprim\/sulfamethoxazole, Klebsiella spp. to most cephalosporin, gentamycin and levofloxacin, Proteus spp. to gentamycin and Enterococcus spp. to gentamycin and quinolones when compared to outpatients. The highest incidence of extensively drug-resistant (XDR) bacteria was among Acinetobacter baumanii, followed by Pseudomonas spp., and Serratia spp. Conclusions: susceptibility. Bacteria identified in inpatients\u2019 positive urine cultures present higher resistance rates to several antibiotics. Our study could be a foundation for a local or even national guideline for the antibiotic treatment of urinary tract infections.<\/jats:p>","DOI":"10.3390\/diseases13030074","type":"journal-article","created":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T10:15:03Z","timestamp":1740996903000},"page":"74","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["In and Outpatients Bacteria Antibiotic Resistances in Positive Urine Cultures from a Tertiary Care Hospital in the Western Part of Romania\u2014A Cross-Sectional Study"],"prefix":"10.3390","volume":"13","author":[{"given":"Nicu","family":"Olariu","sequence":"first","affiliation":[{"name":"Centre for Molecular Research in Nephrology and Vascular Disease, \u201cVictor Babes\u201d University of Medicine and Pharmacy-Faculty of Medicine, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Dialysis Compartment, \u201cPius Brinzeu\u201d Emergency Clinical County University Hospital, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9245-5883","authenticated-orcid":false,"given":"Monica","family":"Licker","sequence":"additional","affiliation":[{"name":"Microbiology Department, Multidisciplinary Research Center of Antimicrobial Resistance, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Microbiology Laboratory, \u201cPius Brinzeu\u201d Emergency Clinical County University Hospital, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3664-1945","authenticated-orcid":false,"given":"Lazar","family":"Chisavu","sequence":"additional","affiliation":[{"name":"Centre for Molecular Research in Nephrology and Vascular Disease, \u201cVictor Babes\u201d University of Medicine and Pharmacy-Faculty of Medicine, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Nephrology Discipline, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Chisavu","sequence":"additional","affiliation":[{"name":"Centre for Molecular Research in Nephrology and Vascular Disease, \u201cVictor Babes\u201d University of Medicine and Pharmacy-Faculty of Medicine, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"\u201cLouis Turcanu\u201d Emergency County Hospital for Children, 300011 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adalbert","family":"Schiller","sequence":"additional","affiliation":[{"name":"Centre for Molecular Research in Nephrology and Vascular Disease, \u201cVictor Babes\u201d University of Medicine and Pharmacy-Faculty of Medicine, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Nephrology Discipline, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana","family":"Marc","sequence":"additional","affiliation":[{"name":"Centre for Molecular Research in Nephrology and Vascular Disease, \u201cVictor Babes\u201d University of Medicine and Pharmacy-Faculty of Medicine, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Nephrology Discipline, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2387-5104","authenticated-orcid":false,"given":"Oana","family":"Albai","sequence":"additional","affiliation":[{"name":"Centre for Molecular Research in Nephrology and Vascular Disease, \u201cVictor Babes\u201d University of Medicine and Pharmacy-Faculty of Medicine, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Department of Second Internal Medicine Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Department of Diabetes, Nutrition and Metabolic Diseases Clinic, \u201cPius Br\u00eenzeu\u201d Emergency Clinical County University Hospital, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei","family":"Paunescu","sequence":"additional","affiliation":[{"name":"Department of Urology, \u201cPius Br\u00eenzeu\u201d Emergency Clinical County University Hospital, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vlad","family":"Tucicovschi","sequence":"additional","affiliation":[{"name":"PhD Department,\u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3220-6623","authenticated-orcid":false,"given":"Adelina","family":"Mihaescu","sequence":"additional","affiliation":[{"name":"Centre for Molecular Research in Nephrology and Vascular Disease, \u201cVictor Babes\u201d University of Medicine and Pharmacy-Faculty of Medicine, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Nephrology Discipline, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Department of Nephrology, \u201cPius Br\u00eenzeu\u201d Emergency Clinical County University Hospital, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6684-1759","authenticated-orcid":false,"given":"Adrian","family":"Apostol","sequence":"additional","affiliation":[{"name":"Centre for Molecular Research in Nephrology and Vascular Disease, \u201cVictor Babes\u201d University of Medicine and Pharmacy-Faculty of Medicine, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Department of Cardiology, \u201cPius Br\u00eenzeu\u201d Emergency Clinical County University Hospital, 300723 Timisoara, Romania"},{"name":"Cardiology Discipline, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,1]]},"reference":[{"key":"ref_1","unstructured":"Antimicrobial Resistance Collaborators (2022). Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis. Lancet, 399, 629\u2013655."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/S1473-3099(18)30605-4","article-title":"Attributable deaths and disability-adjusted life-years caused by infections with antibiotic resistant bacteria in the EU and the European Economic Area in 2015: A population-level modelling analysis","volume":"19","author":"Cassini","year":"2019","journal-title":"Lancet Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e18082","DOI":"10.7554\/eLife.18082","article-title":"Epidemiology and burden of multidrug-resistant bacterial infection in a developing country","volume":"5","author":"Lim","year":"2016","journal-title":"eLife"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","article-title":"Global burden of 369 diseases and injuries in 204 countries and territories, 1990\u20132019: A systematic analysis for the Global Burden of Disease Study 2019","volume":"396","author":"Vos","year":"2020","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"de Kraker, M.E.A., Stewardson, A.J., and Harbarth, S. (2016). Will 10 million people die a year due to antimicrobial resistance by 2050?. PLoS Med., 13.","DOI":"10.1371\/journal.pmed.1002184"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.ejim.2022.01.029","article-title":"Optimizing antibiotic therapies to reduce the risk of bacterial resistance","volume":"99","author":"Bassetti","year":"2022","journal-title":"Eur. J. Intern. Med."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Petca, R.-C., Mare\u0219, C., Petca, A., Negoi\u021b\u0103, S., Popescu, R.-I., Bo\u021b, M., Barab\u00e1s, E., and Chibelean, C.B. (2020). Spectrum and Antibiotic Resistance of Uropathogens in Romanian Females. Antibiotics, 9.","DOI":"10.3390\/antibiotics9080472"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Petca, R.-C., Negoi\u021b\u0103, S., Mare\u0219, C., Petca, A., Popescu, R.-I., and Chibelean, C.B. (2021). Heterogeneity of Antibiotics Multidrug-Resistance Profile of Uropathogens in Romanian Population. Antibiotics, 10.","DOI":"10.3390\/antibiotics10050523"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Chibelean, C.B., Petca, R.-C., Mare\u0219, C., Popescu, R.-I., Enik\u0151, B., Mehedin\u021bu, C., and Petca, A. (2020). A Clinical Perspective on the Antimicrobial Resistance Spectrum of Uropathogens in a Romanian Male Population. Microorganisms, 8.","DOI":"10.3390\/microorganisms8060848"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2369","DOI":"10.2147\/IDR.S312231","article-title":"Prevalence of antibiotic resistance of ESKAPE pathogens over five years in an infectious diseases hospital from South-East of Romania","volume":"14","author":"Arbune","year":"2021","journal-title":"Infect. Drug Resist."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"17","DOI":"10.18683\/germs.2019.1153","article-title":"Antibiotic resistance profiling of pathogenic Enterobacteriaceae from Cluj-Napoca, Romania","volume":"9","author":"Farkas","year":"2019","journal-title":"Germs"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Mare\u0219, C., Petca, R.-C., Popescu, R.-I., Petca, A., Mul\u021bescu, R., Bulai, C.A., Ene, C.V., Geavlete, P.A., Geavlete, B.F., and Jinga, V. (2024). Update on Urinary Tract Infection Antibiotic Resistance\u2014A Retrospective Study in Females in Conjunction with Clinical Data. Life, 14.","DOI":"10.3390\/life14010106"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2147\/TCRM.S123226","article-title":"Urinary tract infections in Romanian patients with diabetes: Prevalence, etiology, and risk factors","volume":"13","author":"Timar","year":"2016","journal-title":"Ther. Clin. Risk Manag."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Sorescu, T., Licker, M., Timar, R., Musuroi, C., Muntean, D., Voinescu, A., Vulcanescu, D.D., Cosnita, A., Musuroi, S.-I., and Timar, B. (2024). Characteristics of Urinary Tract Infections in Patients with Diabetes from Timi\u0219oara, Romania: Prevalence, Etiology, and Antimicrobial Resistance of Uropathogens. Medicina, 60.","DOI":"10.3390\/medicina60111870"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.jgar.2018.11.004","article-title":"NoDARS UTIStudy Group. Antimicrobial resistance of Escherichia coli isolates from outpatient urinary tract infections in women in six European countries including Russia","volume":"17","author":"Ny","year":"2019","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Isac, R., Doros, G., Stolojanu, C.-A., Steflea, R.M., Stroescu, R.F., Olariu, I.-C., Micsescu-Olah, A.-M., and Gafencu, M. (2024). General Characteristics and Current State of Antibiotic Resistance in Pediatric Urinary Tract Infection\u2014A Single Center Experience. Antibiotics, 13.","DOI":"10.3390\/antibiotics13080684"},{"key":"ref_17","unstructured":"Clinical and Laboratory Standards Institute (CLSI) (2020). Performance Standards for Antimicrobial Susceptibility Testing, Clinical and Laboratory Standards Institute. [30th ed.]. CLSI Supplement M100."},{"key":"ref_18","unstructured":"Clinical and Laboratory Standards Institute (CLSI) (2021). Performance Standards for Antimicrobial Susceptibility Testing, Clinical and Laboratory Standards Institute. [31st ed.]. CLSI Supplement M100."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","article-title":"Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: An international expert proposal for interim standard definitions for acquired resistance","volume":"18","author":"Magiorakos","year":"2012","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1097\/01.ju.0000152365.43125.3b","article-title":"Urologic diseases in America project: Analytical methods and principal findings","volume":"173","author":"Litwin","year":"2005","journal-title":"J. Urol."},{"key":"ref_21","unstructured":"Royal College of General Practitioners, Office of Population Censuses and Surveys, Department of Health (1995). Morbidity Statistics from General Practice: Fourth National Study 1991\u20131992, HMSO."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"S272","DOI":"10.1016\/j.ekir.2023.02.613","article-title":"Wcn23-0468 urinary tract infections in chronic kidney disease patients\u2014A Romanian centre experience","volume":"8","author":"Cuiban","year":"2023","journal-title":"Kidney Int. Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.micpath.2016.02.009","article-title":"Breakthroughs in bacterial resistance mechanisms and the potential ways to combat them","volume":"95","author":"Khameneh","year":"2016","journal-title":"Microb. Pathog."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Khan, A., Saraf, V.S., Siddiqui, F., Batool, T., Noreen, Z., Javed, S., Ahmad, A., Alonazi, W.B., Ibrahim, M., and Pucciarelli, S. (2024). Multidrug resistance among uropathogenic clonal group A E. Coli isolates from Pakistani women with uncomplicated urinary tract infections. BMC Microbiol., 24.","DOI":"10.1186\/s12866-024-03221-8"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1007\/s10123-023-00416-3","article-title":"Uropathogenic bacteria and deductive genomics towards antimicrobial resistance, virulence, and potential drug targets","volume":"27","author":"Amin","year":"2024","journal-title":"Int. Microbiol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Reardon, S. (2015). Dramatic rise seen in antibiotic use. Nature, Available online: https:\/\/www.nature.com\/articles\/nature.2015.18383#citeas.","DOI":"10.1038\/nature.2015.18383"},{"key":"ref_27","unstructured":"(2024, October 01). Available online: https:\/\/www.thebusinessresearchcompany.com\/report\/multidrug-resistant-bacteria-global-market-report."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"100011","DOI":"10.1016\/j.crphar.2020.100011","article-title":"Broad-spectrum therapeutics: A new antimicrobial class","volume":"2","author":"Firth","year":"2021","journal-title":"Curr. Res. Pharmacol. Drug Discov."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1056\/NEJMoa1306801","article-title":"Emerging Infections Program Healthcare-Associated Infections and Antimicrobial Use Prevalence Survey Team. Multistate point-prevalence survey of health care-associated infections","volume":"370","author":"Magill","year":"2014","journal-title":"N. Engl. J. Med."}],"container-title":["Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-9721\/13\/3\/74\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:45:40Z","timestamp":1760028340000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-9721\/13\/3\/74"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,1]]},"references-count":29,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["diseases13030074"],"URL":"https:\/\/doi.org\/10.3390\/diseases13030074","relation":{},"ISSN":["2079-9721"],"issn-type":[{"value":"2079-9721","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,1]]}}}