{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T12:25:42Z","timestamp":1787142342666,"version":"build-2736575974"},"reference-count":23,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"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>Background and Objectives: Urinary tract infections are common in clinical practice, but in hospital settings, especially among older and catheterized patients, the microbial ecology and resistance burden may differ substantially from community-acquired infections. Local surveillance is therefore essential to support appropriate empirical treatment and antimicrobial stewardship. The objective is to describe the microbiological epidemiology of urinary isolates in a tertiary hospital and evaluate temporal trends in antimicrobial resistance among the most frequently isolated microorganisms. Materials and Methods: This retrospective observational study analyzed microbiology laboratory data from Tor Vergata University Hospital, Rome, Italy, collected from January 2022 to June 2025. After WHONET-based deduplication using a 30-day repeat-isolate rule, 5788 deduplicated urinary isolates and 85,888 microorganism\u2013drug associations were included. Descriptive analyses, cumulative antibiograms\/antimycograms, and quarterly resistance trends were assessed using univariable and multivariable regression analyses. Results: The population was predominantly elderly, inpatient, and catheter-exposed. Gram-negative organisms predominated, followed by Gram-positive bacteria and fungi. The most frequent isolates were E. coli, K. pneumoniae, E. faecalis, and C. albicans. Although microorganism distribution remained broadly stable over time, resistance increased in several clinically relevant organism\u2013drug combinations, especially among major Enterobacterales. Conclusions: In this high-complexity hospital population, urinary isolates showed a relatively stable microorganism distribution but progressive changes in susceptibility among selected urinary isolates. These findings support setting-specific microbiological surveillance and stewardship-informed empirical treatment strategies.<\/jats:p>","DOI":"10.3390\/medicina62081595","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T11:04:12Z","timestamp":1787137452000},"page":"1595","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Microbial Epidemiology and Antimicrobial Resistance Trends in Urinary Isolates from a Tertiary Hospital in Rome, Italy: A Retrospective Study (2022\u20132025)"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6295-9848","authenticated-orcid":false,"given":"Fabio","family":"Ingravalle","sequence":"first","affiliation":[{"name":"Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy"},{"name":"Local Health Authority ASL Roma 1, 00193 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9943-9130","authenticated-orcid":false,"given":"Marco","family":"Ciotti","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology and Virology, Tor Vergata University Hospital, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5464-5822","authenticated-orcid":false,"given":"Giovanni","family":"Gaetti","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana di Medicina e Divulgazione (SIMED), 20054 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2209-6245","authenticated-orcid":false,"given":"Giustino","family":"Morlino","sequence":"additional","affiliation":[{"name":"Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy"},{"name":"Local Health Authority ASL Roma 1, 00193 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giampiera","family":"Bulfone","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d (DGFI), University of Catania, 95131 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorian","family":"Bardhi","sequence":"additional","affiliation":[{"name":"Department Medicine, Hospital Health Management AOU delle Marche,  60126 Ancona, Italy"},{"name":"Department of Biomedical Science and Public Health, Marche Polytechnic University, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1495-0165","authenticated-orcid":false,"given":"Pamela","family":"Barbadoro","sequence":"additional","affiliation":[{"name":"Department of Biomedical Science and Public Health, Marche Polytechnic University, 60126 Ancona, Italy"},{"name":"Hospital Hygiene Unit, Azienda Ospedaliero-Universitaria delle Marche, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7899-889X","authenticated-orcid":false,"given":"Francesca","family":"Pica","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Di Carlo","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Tor Vergata University Hospital, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Livio","family":"Serafinelli","sequence":"additional","affiliation":[{"name":"Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4915-7733","authenticated-orcid":false,"given":"Antonio","family":"Vinci","sequence":"additional","affiliation":[{"name":"Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy"},{"name":"Azienda Regionale Emergenza Sanitaria ARES 118, 00149 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5884-161X","authenticated-orcid":false,"given":"Massimo","family":"Maurici","sequence":"additional","affiliation":[{"name":"Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.eururo.2024.03.035","article-title":"European Association of Urology Guidelines on Urological Infections: Summary of the 2024 Guidelines","volume":"86","author":"Kranz","year":"2024","journal-title":"Eur. Urol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e2444495","DOI":"10.1001\/jamanetworkopen.2024.44495","article-title":"Guidelines for the Prevention, Diagnosis, and Management of Urinary Tract Infections in Pediatrics and Adults: A WikiGuidelines Group Consensus Statement","volume":"7","author":"Nelson","year":"2024","journal-title":"JAMA Netw. Open"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.euros.2025.03.010","article-title":"Classification of Urinary Tract Infections in 2025: Moving Beyond Uncomplicated and Complicated","volume":"75","author":"Bonkat","year":"2025","journal-title":"Eur. Urol. Open Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1756287218814382","DOI":"10.1177\/1756287218814382","article-title":"Risk Factors and Predisposing Conditions for Urinary Tract Infection","volume":"11","author":"Storme","year":"2019","journal-title":"Ther. Adv. Urol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1053\/j.ajkd.2023.08.009","article-title":"Urinary Tract Infections: Core Curriculum 2024","volume":"83","author":"Blair","year":"2024","journal-title":"Am. J. Kidney Dis. Off. J. Natl. Kidney Found."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/j.ucl.2015.05.010","article-title":"Treatment of Fungal Urinary Tract Infection","volume":"42","author":"Thomas","year":"2015","journal-title":"Urol. Clin. N. Am."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"108688","DOI":"10.1016\/j.pharmthera.2024.108688","article-title":"Current State and Novel Outlook on Prevention and Treatment of Rising Antibiotic Resistance in Urinary Tract Infections","volume":"261","author":"Sher","year":"2024","journal-title":"Pharmacol. Ther."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Trautner, B.W., Cort\u00e9s-Penfield, N.W., Gupta, K., Hirsch, E.B., Horstman, M., Moran, G.J., Colgan, R., O\u2019Horo, J.C., Ashraf, M.S., and Connolly, S. (2025). Clinical Practice Guideline by Infectious Diseases Society of America (IDSA): 2025 Guideline on Management and Treatment of Complicated Urinary Tract Infections: Duration of Antibiotics for Complicated UTI. Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am., Epub ahead of printing.","DOI":"10.1093\/cid\/ciaf462"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Ingravalle, F., Maurici, M., Vinci, A., Di Carlo, S., D\u2019Agostini, C., Pica, F., and Ciotti, M. (2025). Time Trends in Prevalence and Antimicrobial Resistance of Respiratory Pathogens in a Tertiary Hospital in Rome, Italy: A Retrospective Analysis (2018\u20132023). Antibiotics, 14.","DOI":"10.3390\/antibiotics14090932"},{"key":"ref_10","unstructured":"(2026, June 26). WHONET Software. Available online: https:\/\/whonet.org\/software.html."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Ingravalle, F., Vinci, A., Ciotti, M., Fontana, C., Pica, F., Sebastiani, E., Donnoli, C., Guido Rizzo, M., Tedesco, D., and D\u2019Arezzo, S. (2025). A Six-Step Protocol for Monitoring Antimicrobial Resistance Trends Using WHONET and R: Real-World Application and R Code Integration. Methods Protoc., 8.","DOI":"10.3390\/mps8050115"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Mohamed, A.H., Sheikh Omar, N.M., Osman, M.M., Mohamud, H.A., Eraslan, A., and Gur, M. (2022). Antimicrobial Resistance and Predisposing Factors Associated with Catheter-Associated UTI Caused by Uropathogens Exhibiting Multidrug-Resistant Patterns: A 3-Year Retrospective Study at a Tertiary Hospital in Mogadishu, Somalia. Trop. Med. Infect. Dis., 7.","DOI":"10.3390\/tropicalmed7030042"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Shen, L., Fu, T., Huang, L., Sun, H., Wang, Y., Sun, L., Lu, X., Zhang, J., Yang, Z., and Ni, C. (2023). 7295 Elderly Hospitalized Patients with Catheter-Associated Urinary Tract Infection: A Case-Control Study. BMC Infect. Dis., 23.","DOI":"10.1186\/s12879-023-08711-0"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.idc.2013.10.003","article-title":"Diagnosis and Management of Urinary Tract Infection in the Emergency Department and Outpatient Settings","volume":"28","author":"Takhar","year":"2014","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_15","unstructured":"(2026, June 26). Antimicrobial Resistance in the EU\/EEA (EARS-Net)\u2014Annual Epidemiological Report for 2024. Available online: https:\/\/www.ecdc.europa.eu\/en\/publications-data\/antimicrobial-resistance-eueea-ears-net-annual-epidemiological-report-2024."},{"key":"ref_16","unstructured":"(2026, June 26). EpiCentro Urinocolture\u2014Sorveglianza dell\u2019Antibiotico-Resistenza\u2014AR-ISS. Available online: https:\/\/www.epicentro.iss.it\/antibiotico-resistenza\/ar-iss-rapporto-urinocolture."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Bielec, F., Wenecka, M., Brauncajs, M., and Pastuszak-Lewandoska, D. (2023). Analysis of Cumulative Antibiogram Reports in Search for Optimal Empirical Urinary Tract Infection Treatment at the Central Teaching Hospital of the Medical University of Lodz, Poland: Results of a 3-Year Surveillance. J. Clin. Med., 12.","DOI":"10.3390\/jcm12196270"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"101197","DOI":"10.1016\/j.lanepe.2024.101197","article-title":"ISIS-AR study group Dynamic Association of Antimicrobial Resistance in Urinary Isolates of Escherichia Coli and Klebsiella Pneumoniae between Primary Care and Hospital Settings in the Netherlands (2008\u20132020): A Population-Based Study","volume":"50","author":"Verbon","year":"2025","journal-title":"Lancet Reg. Health Eur."},{"key":"ref_19","unstructured":"(2026, June 26). Antimicrobial Resistance Surveillance in Europe 2023\u20132021 Data. Available online: https:\/\/www.who.int\/europe\/publications\/i\/item\/9789289058537."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2845","DOI":"10.4102\/AJLM.v14i1.2845","article-title":"A Retrospective Analysis of Uropathogens Isolated and Antimicrobial Susceptibility Patterns at a Regional Hospital in North West Province, South Africa","volume":"14","author":"Teixeira","year":"2025","journal-title":"Afr. J. Lab. Med."},{"key":"ref_21","first-page":"156","article-title":"Candiduria in Hospitalized Patients and Identification of Isolated Candida Species by Morphological and Molecular Methods in Ilam, Iran","volume":"48","author":"Fazeli","year":"2019","journal-title":"Iran. J. Public Health"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"5917","DOI":"10.2147\/IDR.S555207","article-title":"Species Distribution, Drug Resistance, and Risk Determinants of Candida UTIs: A Five-Year Retrospective Study in Beijing","volume":"18","author":"Cao","year":"2025","journal-title":"Infect. Drug Resist."},{"key":"ref_23","first-page":"1610","article-title":"Prevalence and Antifungal Susceptibility Profiles of Candida Isolates Among Patients with Candiduria: A Multiplex PCR Assay","volume":"11","author":"Darabian","year":"2025","journal-title":"Curr. Med. Mycol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/8\/1595\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T11:38:05Z","timestamp":1787139485000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/8\/1595"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,19]]},"references-count":23,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["medicina62081595"],"URL":"https:\/\/doi.org\/10.3390\/medicina62081595","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,19]]}}}