{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T05:18:37Z","timestamp":1787721517603,"version":"build-2784847793"},"reference-count":36,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Science, Technological Development, and Innovation of the Republic of Serbia","award":["200110"],"award-info":[{"award-number":["200110"]}]},{"award":["200110"],"award-info":[{"award-number":["200110"]}],"id":[{"id":"https:\/\/ror.org\/01znas443","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100023848","name":"Innovation Fund of the Republic of Serbia","doi-asserted-by":"crossref","award":["50-138"],"award-info":[{"award-number":["50-138"]}],"id":[{"id":"10.13039\/501100023848","id-type":"DOI","asserted-by":"crossref"}]},{"award":["50-138"],"award-info":[{"award-number":["50-138"]}],"id":[{"id":"https:\/\/ror.org\/01serpn70","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>One of the most important adverse consequences of antibiotic use is the development of bacterial resistance. This study investigated the prevalence and antimicrobial resistance patterns of multidrug-resistant (MDR) Escherichia coli in a tertiary care hospital during 2013\u20132015 and 2024, together with trends in antibiotic consumption and the molecular characteristics of resistance genes in 2024 isolates. Identification and susceptibility testing were performed using the Vitek\u00ae 2 system, antibiotic consumption was assessed according to WHO ATC\/DDD methodology, and resistance genes were detected by PCR. No significant differences were observed in the total number of isolates, patients, or the proportion of E. coli isolates during 2013\u20132015. However, the isolation rate of MDR E. coli significantly declined from 36.9% to 30%. Total antibiotic consumption remained stable, with no correlation between consumption and MDR isolation rates, although ampicillin resistance increased significantly. In 2024, MDR E. coli accounted for 24.3% of isolates despite lower antibiotic consumption. Compared with 2015, resistance significantly increased to amoxicillin\u2013clavulanic acid, cefotaxime, cefepime, ceftazidime, ciprofloxacin, and levofloxacin, while ceftriaxone resistance decreased. The blaCTX-M gene was detected in 53% of bloodstream isolates, indicating widespread dissemination of ESBL-producing E. coli and highlighting the need for continuous surveillance and antimicrobial stewardship.<\/jats:p>","DOI":"10.3390\/life16091392","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T09:20:02Z","timestamp":1787563202000},"page":"1392","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Increased Prevalence of Multidrug-Resistant Escherichia coli as an Adverse Effect of Excessive Antibiotic Use in a Tertiary Care Hospital in Serbia"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6282-7092","authenticated-orcid":false,"given":"Vladimir","family":"Zivanovic","sequence":"first","affiliation":[{"name":"Department of General Surgery, University Hospital Centre \u201cDr Dragisa Misovic\u2013Dedinje\u201d, 11040 Belgrade, Serbia"},{"name":"Department of General Surgery with Anesthesiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teodora","family":"Vitorovic","sequence":"additional","affiliation":[{"name":"Department of General Surgery, University Hospital Centre \u201cDr Dragisa Misovic\u2013Dedinje\u201d, 11040 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dejan","family":"Stojakov","sequence":"additional","affiliation":[{"name":"Department of General Surgery, University Hospital Centre \u201cDr Dragisa Misovic\u2013Dedinje\u201d, 11040 Belgrade, Serbia"},{"name":"Department of General Surgery with Anesthesiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biljana","family":"Carevic","sequence":"additional","affiliation":[{"name":"Special Advisor for Infection Prevention and Control, Oslo University Hospital, N-0424 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Bukarica","sequence":"additional","affiliation":[{"name":"Institute for Cardiovascular Diseases, Dedinje, University of Belgrade, 11040 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilija","family":"Doknic","sequence":"additional","affiliation":[{"name":"Faculty of Organizational Sciences, University of Belgrade, 11010 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5503-8837","authenticated-orcid":false,"given":"Ljiljana","family":"Gojkovic Bukarica","sequence":"additional","affiliation":[{"name":"Institute of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"ref_1","unstructured":"Centers for Disease Control and Prevention (2026, June 06). 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Dis."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/9\/1392\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T04:22:00Z","timestamp":1787718120000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/9\/1392"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,24]]},"references-count":36,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["life16091392"],"URL":"https:\/\/doi.org\/10.3390\/life16091392","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,24]]}}}