{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T05:49:53Z","timestamp":1788587393659,"version":"build-2803163510"},"reference-count":42,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Introduction: Urinary tract infections (UTIs) in male patients are a topic that has received less attention in the medical literature. Current management strategies recommended by most guidelines are largely based on research involving female populations, which limits their applicability to men, in whom UTIs are often considered complicated. While the COVID-19 pandemic has brought about many changes in antibiotic treatment, this study aims to compare antimicrobial resistance patterns of uropathogens in male patients between the COVID-19 pandemic and post-pandemic periods. Materials and Methods: A retrospective descriptive study including urine-culture positive cases in male patients was conducted at a tertiary-level university urology center in Bucharest, Romania. To assess temporal trends, the analysis used four selected six-month intervals during the COVID-19 pandemic (2020\u20132022) and the post-pandemic period (2023\u20132025). Inclusion was limited to adult male patients aged at least 18 years who had a single identified pathogen and significant bacteriuria (at least 105 CFU\/mL). Duplicate and polymicrobial samples were excluded. In accordance with CLSI guidelines, bacteria were identified and antimicrobial susceptibility was assessed using standard microbiological methods. Statistical analysis was made using Python 3.11.3. Results: A total of 3158 urine positive urine cultures from male patients were included. Gram-negative isolates were the most frequent, with E. coli being the most common urinary pathogen, followed by Klebsiella. The most common Gram-positive isolate was Enterococcus. Antimicrobial resistance in Gram-negative pathogens were higher in the post-pandemic period compared to the pandemic period, particularly to amoxicillin-clavulanic acid, and levofloxacin, with carbapenem resistance exceeding 20%. E. coli showed increased resistance rates to levofloxacin, and amoxicillin-clavulanic acid, and ceftazidime. Resistance of Klebsiella spp. exceeded 30% for imipenem and meropenem. Resistance to amoxicillin-clavulanic, ceftazidime, and imipenem acid increased in Proteus spp. Even though Pseudomonas spp.demonstrated higher resistance rates to several antibiotics, no statistical differences were observed. Enterococcus spp. showed a stable profile, demonstrating resistance to levofloxacin, penicillin, and ampicillin. Conclusion: Among male patients, uropathogens\u2019 antimicrobial resistance was higher in the post-pandemic period compared to the COVID-19 period, particularly among Gram-negative bacteria. Regarding empirical therapy, there are significant concerns regarding the rise in resistance to antibiotics such as fluoroquinolones and \u03b2-lactams, as well as the emergence of resistance to carbapenems.<\/jats:p>","DOI":"10.3390\/medicina62050889","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T07:36:23Z","timestamp":1778052983000},"page":"889","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparative Analysis of Antimicrobial Resistance in Male Uropathogens Before and After the COVID-19 Pandemic: A Single-Center Study from Romania"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6614-2816","authenticated-orcid":false,"given":"R\u0103zvan-Ionu\u021b","family":"Popescu","sequence":"first","affiliation":[{"name":"Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania"},{"name":"Department of Urology, \u201cProf. Dr. Th. Burghele\u201d Clinical Hospital, 20 Panduri Str., 050659 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4496-1535","authenticated-orcid":false,"given":"R\u0103zvan-Cosmin","family":"Petca","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania"},{"name":"Department of Urology, \u201cProf. Dr. Th. Burghele\u201d Clinical Hospital, 20 Panduri Str., 050659 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1005-7388","authenticated-orcid":false,"given":"Cristian","family":"Mare\u0219","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania"},{"name":"Department of Urology, \u201cSaint John\u201d Clinical Emergency Hospital, 13 Vitan-Barzesti Str., 042122 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4890-0978","authenticated-orcid":false,"given":"Aida","family":"Petca","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania"},{"name":"Department of Obstetrics and Gynecology, CF2 Clinical Hospital, 63 Marasti Blvd., 011464 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Bassil","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7632-5328","authenticated-orcid":false,"given":"Viorel","family":"Jinga","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania"},{"name":"Department of Urology, \u201cProf. Dr. Th. Burghele\u201d Clinical Hospital, 20 Panduri Str., 050659 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"key":"ref_1","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_2","doi-asserted-by":"crossref","first-page":"1756287219832172","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. 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