The Etiology and Antimicrobial Susceptibility of Community-Onset Urinary Tract Infections in a Low-Resource/High-Resistance Area of Latin America
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....
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MDPI AG
2025-02-01
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| author | Maria Micieli Selene Rebecca Boncompagni Tiziana Di Maggio Yenny Bertha Mamani Ramos Antonia Mantella Ana Liz Villagrán Carmen Angélica Revollo Yelma Evelin Esther Fortún Fernández Michele Spinicci Marianne Strohmeyer Lucia Pallecchi Gian Maria Rossolini Alessandro Bartoloni |
| author_facet | Maria Micieli Selene Rebecca Boncompagni Tiziana Di Maggio Yenny Bertha Mamani Ramos Antonia Mantella Ana Liz Villagrán Carmen Angélica Revollo Yelma Evelin Esther Fortún Fernández Michele Spinicci Marianne Strohmeyer Lucia Pallecchi Gian Maria Rossolini Alessandro Bartoloni |
| author_sort | Maria Micieli |
| collection | DOAJ |
| description | 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, <i>bla</i><sub>CTX-M</sub> and <i>mcr</i> 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. <i>Escherichia coli</i> was the most prevalent pathogen (86.6%), followed by <i>Klebsiella pneumoniae</i> (5.4%) and <i>Proteus</i> spp. (2.2%). Very high resistance rates (>50%) were observed for ampicillin, trimethoprim–sulfamethoxazole and fluoroquinolones, high resistance rates (>20%) for amoxicillin–clavulanate, third-generation cephalosporins and gentamicin, while lower resistance rates (<10%) were observed for nitrofurantoin and fosfomycin. The prevalence of <i>bla</i><sub>CTX-M</sub> among <i>E. coli</i> was high (26.7%). Colistin resistance was detected in 3.4% of <i>E. coli</i>, mostly associated with <i>mcr</i> genes. CO-UTIs from this area were characterized by high resistance rates to commonly used antibiotics (trimethoprim–sulfamethoxazole, amoxicillin–clavulanic acid and ciprofloxacin), highlighting the importance of knowledge of the local epidemiology to inform the selection of appropriate empirical antibiotic regimens. |
| format | Article |
| id | doaj-art-30d4dddaebb54fe384d540c48c36daff |
| institution | DOAJ |
| issn | 2414-6366 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | MDPI AG |
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| series | Tropical Medicine and Infectious Disease |
| spelling | doaj-art-30d4dddaebb54fe384d540c48c36daff2025-08-20T02:43:04ZengMDPI AGTropical Medicine and Infectious Disease2414-63662025-02-011036410.3390/tropicalmed10030064The Etiology and Antimicrobial Susceptibility of Community-Onset Urinary Tract Infections in a Low-Resource/High-Resistance Area of Latin AmericaMaria Micieli0Selene Rebecca Boncompagni1Tiziana Di Maggio2Yenny Bertha Mamani Ramos3Antonia Mantella4Ana Liz Villagrán5Carmen Angélica Revollo Yelma6Evelin Esther Fortún Fernández7Michele Spinicci8Marianne Strohmeyer9Lucia Pallecchi10Gian Maria Rossolini11Alessandro Bartoloni12Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, ItalyDepartment of Experimental and Clinical Medicine, University of Florence, 50134 Florence, ItalyDepartment of Medical Biotechnologies, University of Siena, 53100 Siena, ItalyHospital Básico Villa Montes, Villa Montes 00591, BoliviaDepartment of Experimental and Clinical Medicine, University of Florence, 50134 Florence, ItalyHospital Básico Villa Montes, Villa Montes 00591, BoliviaInstituto Nacional de Laboratorios de Salud “Dr. Nestor Morales Villazón” (INLASA), La Paz 00201, BoliviaInstituto Nacional de Laboratorios de Salud “Dr. Nestor Morales Villazón” (INLASA), La Paz 00201, BoliviaDepartment of Experimental and Clinical Medicine, University of Florence, 50134 Florence, ItalyDepartment of Experimental and Clinical Medicine, University of Florence, 50134 Florence, ItalyDepartment of Medical Biotechnologies, University of Siena, 53100 Siena, ItalyDepartment of Experimental and Clinical Medicine, University of Florence, 50134 Florence, ItalyDepartment of Experimental and Clinical Medicine, University of Florence, 50134 Florence, ItalyUrinary 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, <i>bla</i><sub>CTX-M</sub> and <i>mcr</i> 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. <i>Escherichia coli</i> was the most prevalent pathogen (86.6%), followed by <i>Klebsiella pneumoniae</i> (5.4%) and <i>Proteus</i> spp. (2.2%). Very high resistance rates (>50%) were observed for ampicillin, trimethoprim–sulfamethoxazole and fluoroquinolones, high resistance rates (>20%) for amoxicillin–clavulanate, third-generation cephalosporins and gentamicin, while lower resistance rates (<10%) were observed for nitrofurantoin and fosfomycin. The prevalence of <i>bla</i><sub>CTX-M</sub> among <i>E. coli</i> was high (26.7%). Colistin resistance was detected in 3.4% of <i>E. coli</i>, mostly associated with <i>mcr</i> genes. CO-UTIs from this area were characterized by high resistance rates to commonly used antibiotics (trimethoprim–sulfamethoxazole, amoxicillin–clavulanic acid and ciprofloxacin), highlighting the importance of knowledge of the local epidemiology to inform the selection of appropriate empirical antibiotic regimens.https://www.mdpi.com/2414-6366/10/3/64Boliviacommunity-onset urinary tract infectionsMDRempirical therapy<i>Escherichia coli</i> |
| spellingShingle | Maria Micieli Selene Rebecca Boncompagni Tiziana Di Maggio Yenny Bertha Mamani Ramos Antonia Mantella Ana Liz Villagrán Carmen Angélica Revollo Yelma Evelin Esther Fortún Fernández Michele Spinicci Marianne Strohmeyer Lucia Pallecchi Gian Maria Rossolini Alessandro Bartoloni The Etiology and Antimicrobial Susceptibility of Community-Onset Urinary Tract Infections in a Low-Resource/High-Resistance Area of Latin America Tropical Medicine and Infectious Disease Bolivia community-onset urinary tract infections MDR empirical therapy <i>Escherichia coli</i> |
| title | The Etiology and Antimicrobial Susceptibility of Community-Onset Urinary Tract Infections in a Low-Resource/High-Resistance Area of Latin America |
| title_full | The Etiology and Antimicrobial Susceptibility of Community-Onset Urinary Tract Infections in a Low-Resource/High-Resistance Area of Latin America |
| title_fullStr | The Etiology and Antimicrobial Susceptibility of Community-Onset Urinary Tract Infections in a Low-Resource/High-Resistance Area of Latin America |
| title_full_unstemmed | The Etiology and Antimicrobial Susceptibility of Community-Onset Urinary Tract Infections in a Low-Resource/High-Resistance Area of Latin America |
| title_short | The Etiology and Antimicrobial Susceptibility of Community-Onset Urinary Tract Infections in a Low-Resource/High-Resistance Area of Latin America |
| title_sort | etiology and antimicrobial susceptibility of community onset urinary tract infections in a low resource high resistance area of latin america |
| topic | Bolivia community-onset urinary tract infections MDR empirical therapy <i>Escherichia coli</i> |
| url | https://www.mdpi.com/2414-6366/10/3/64 |
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