{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:46:45Z","timestamp":1785422805690,"version":"3.56.0"},"reference-count":37,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T00:00:00Z","timestamp":1776470400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"VICTOR BABES UNIVERSITY OF MEDICINE AND PHARMACY TIMISOARA"},{"id":[{"id":"https:\/\/ror.org\/00afdp487","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>The escalating prevalence of antimicrobial resistance (AMR) in Gram-negative uropathogens represents a critical bottleneck in global clinical management. This study evaluated shifting resistance phenotypes and patient risk profiles to identify independent predictors of multidrug resistance (MDR). A comprehensive retrospective analysis was conducted on a cohort of 318 patients, utilizing statistical modeling to evaluate the impact of demographics, prolonged hospitalization, and comorbidities on MDR. Findings revealed a significant longitudinal exacerbation of resistance since 2012. A majority of Klebsiella pneumoniae strains and nearly all Myroides and Providencia species exhibited high-level resistance to cephalosporin\/beta-lactamase inhibitor combinations. While high-dose piperacillin-tazobactam remains a therapeutic alternative, its utility is increasingly constrained by escalating Minimum Inhibitory Concentrations (MICs) for Klebsiella and Escherichia coli (E. coli). Statistical modeling identified advanced age as the primary independent driver, with MDR risk increasing linearly with every additional year of age. Furthermore, indwelling catheterization was strongly associated with resistant infections, while human immunodeficiency virus (HIV) status emerged as a significant cofactor in the selection of highly resistant strains. These findings underscore the need for a critical recalibration of therapeutic frameworks, prioritizing precision-guided stewardship. Pharmacodynamic optimization, through extended or continuous infusion regimens and individualized loading doses, is essential to mitigate the clinical burden of resistant pathogens within vulnerable geriatric cohorts.<\/jats:p>","DOI":"10.3390\/microorganisms14040916","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T13:22:47Z","timestamp":1776691367000},"page":"916","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Predictors and Pathogen Resistance Dynamics in Hospitalized Patients with Urinary Tract Infections: A 2025 Institutional Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Ruxandra","family":"Laza","sequence":"first","affiliation":[{"name":"Department XIII, Discipline of Infectious Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioana-Melinda","family":"Luput-Andrica","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adelina-Raluca","family":"Marinescu","sequence":"additional","affiliation":[{"name":"Department XIII, Discipline of Infectious Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6567-4407","authenticated-orcid":false,"given":"Talida-Georgiana","family":"Cut","sequence":"additional","affiliation":[{"name":"Department XIII, Discipline of Infectious Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"},{"name":"Center for Ethics in Human Genetic Identification, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Herlo","sequence":"additional","affiliation":[{"name":"Department XIII, Discipline of Infectious Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andra-Elena","family":"Saizu","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreea-Cristina","family":"Floruncut","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narcisa","family":"Nicolescu","sequence":"additional","affiliation":[{"name":"Department XIII, Discipline of Infectious Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2136-5493","authenticated-orcid":false,"given":"Romanita","family":"Jumanca","sequence":"additional","affiliation":[{"name":"Romanian and Foreign Languages Department, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela-Ica","family":"Rosoha","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Voichita Elena","family":"Lazureanu","sequence":"additional","affiliation":[{"name":"Department XIII, Discipline of Infectious Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romosan","family":"Ana-Maria","sequence":"additional","affiliation":[{"name":"Psihiatry, Neurosciences Department, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"4702","DOI":"10.1038\/s41598-025-89240-5","article-title":"Epidemiological trends and predictions of urinary tract infections in the global burden of disease study 2021","volume":"15","author":"He","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Hong, R., Hou, Y., Xu, X., Lang, J., Jin, Y., Zeng, X., Zhang, X., Tian, G., and You, X. (2022). 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