{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T03:35:11Z","timestamp":1793504111435,"version":"4.5.0"},"reference-count":31,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T00:00:00Z","timestamp":1740614400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Regione Toscana (Italy)","award":["PIR18\/19"],"award-info":[{"award-number":["PIR18\/19"]}]},{"name":"Ministry of Education, University and Research (Italy) Excellence Departments","award":["PIR18\/19"],"award-info":[{"award-number":["PIR18\/19"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Urinary tract infections (UTIs) are common and are typically treated empirically, based on local antimicrobial resistance (AMR) data, which are often scarce in low- and middle-income countries. This study examines the AMR patterns of pathogens causing community-onset (CO) UTIs in the Bolivian Chaco. Urine samples were collected from subjects with suspected CO-UTIs and analyzed by culture techniques. Significant isolates were tested for their antimicrobial susceptibility. Additionally, blaCTX-M and mcr genes were searched for using real-time PCR. A total of 361 CO-UTI episodes were diagnosed among 731 subjects from February 2020 to November 2021. The cases included uncomplicated and complicated UTIs (58.2% and 41.8%, respectively), with females accounting for the majority (85.3%) of cases. Escherichia coli was the most prevalent pathogen (86.6%), followed by Klebsiella pneumoniae (5.4%) and Proteus spp. (2.2%). Very high resistance rates (&gt;50%) were observed for ampicillin, trimethoprim\u2013sulfamethoxazole and fluoroquinolones, high resistance rates (&gt;20%) for amoxicillin\u2013clavulanate, third-generation cephalosporins and gentamicin, while lower resistance rates (&lt;10%) were observed for nitrofurantoin and fosfomycin. The prevalence of blaCTX-M among E. coli was high (26.7%). Colistin resistance was detected in 3.4% of E. coli, mostly associated with mcr genes. CO-UTIs from this area were characterized by high resistance rates to commonly used antibiotics (trimethoprim\u2013sulfamethoxazole, amoxicillin\u2013clavulanic acid and ciprofloxacin), highlighting the importance of knowledge of the local epidemiology to inform the selection of appropriate empirical antibiotic regimens.<\/jats:p>","DOI":"10.3390\/tropicalmed10030064","type":"journal-article","created":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T08:05:54Z","timestamp":1740729954000},"page":"64","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The Etiology and Antimicrobial Susceptibility of Community-Onset Urinary Tract Infections in a Low-Resource\/High-Resistance Area of Latin America"],"prefix":"10.3390","volume":"10","author":[{"given":"Maria","family":"Micieli","sequence":"first","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4807-4343","authenticated-orcid":false,"given":"Selene Rebecca","family":"Boncompagni","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziana","family":"Di Maggio","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yenny Bertha Mamani","family":"Ramos","sequence":"additional","affiliation":[{"name":"Hospital B\u00e1sico Villa Montes, Villa Montes 00591, Bolivia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Mantella","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Liz","family":"Villagr\u00e1n","sequence":"additional","affiliation":[{"name":"Hospital B\u00e1sico Villa Montes, Villa Montes 00591, Bolivia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen Ang\u00e9lica Revollo","family":"Yelma","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Laboratorios de Salud \u201cDr. Nestor Morales Villaz\u00f3n\u201d (INLASA), La Paz 00201, Bolivia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelin Esther Fort\u00fan","family":"Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Laboratorios de Salud \u201cDr. Nestor Morales Villaz\u00f3n\u201d (INLASA), La Paz 00201, Bolivia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5377-7118","authenticated-orcid":false,"given":"Michele","family":"Spinicci","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"},{"name":"Infectious and Tropical Diseases Unit, Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Strohmeyer","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Pallecchi","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9386-0434","authenticated-orcid":false,"given":"Gian Maria","family":"Rossolini","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"},{"name":"Microbiology and Virology Unit, Florence Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9758-1523","authenticated-orcid":false,"given":"Alessandro","family":"Bartoloni","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"},{"name":"Infectious and Tropical Diseases Unit, Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,27]]},"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. 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