Antibiotic resistance patterns of community-acquired urinary tract infections caused by Enterobacterales in Albania

Background: The escalating rates of antibiotic resistance, especially through Extended-Spectrum Beta-Lactamase (ESBL) production within Enterobacterales represents a critical challenge in the effective management and treatment of urinary tract infections (UTIs). This study aims to examine the distri...

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Main Authors: Silvi Bozo, Irida Ikonomi Hoxha, Silva Tafaj, Teuta Xhindi
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:New Microbes and New Infections
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Online Access:http://www.sciencedirect.com/science/article/pii/S2052297525000319
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author Silvi Bozo
Irida Ikonomi Hoxha
Silva Tafaj
Teuta Xhindi
author_facet Silvi Bozo
Irida Ikonomi Hoxha
Silva Tafaj
Teuta Xhindi
author_sort Silvi Bozo
collection DOAJ
description Background: The escalating rates of antibiotic resistance, especially through Extended-Spectrum Beta-Lactamase (ESBL) production within Enterobacterales represents a critical challenge in the effective management and treatment of urinary tract infections (UTIs). This study aims to examine the distribution of pathogens, assess the prevalence of ESBL production, and analyze the resistance patterns of Enterobacterales isolated from outpatient urocultures in Albania. Methods: Midstream urine specimens from 406 patients were cultured on MacConkey agar and analyzed using the VITEK 2 automated system (bioMérieux, France). Samples with a bacterial count of ≥100,000 CFU/ml were considered positive for UTIs. Statistical analyses were conducted using SPSS software, version 27.0. Results: Among the analyzed samples, 271 (66.7 %) tested positive for UTIs. Gram-negative bacteria, particularly Enterobacterales (88.5 %) were the most common while E. coli was the predominant microorganism (87.0 %). The demographic analysis revealed that females (74.5 %) and young adults (18–34 years) (54.0 %) were the most affected groups. High resistance rates were observed for tetracycline (55.0 %), piperacillin (43.0 %), and trimethoprim (38.5 %), while resistance to meropenem was very low (1.0 %). A total of 25 isolates (12.5 %) were positive for ESBL production. Among the E. coli isolates, 12.1 % (21/174) tested positive. Statistical analysis indicated a significant association between female gender and increased antibiotic resistance. Conclusions: Our findings highlight the significant issue of antibiotic resistance in community-acquired UTIs in Albania, particularly involving Enterobacterales. Ongoing surveillance and tailored treatment strategies, alongside antibiotic stewardship programs, are crucial to address this growing public health concern.
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spelling doaj-art-95fc0c24cede4aab95ee1c20cc5da7ef2025-08-20T03:10:21ZengElsevierNew Microbes and New Infections2052-29752025-06-016510159210.1016/j.nmni.2025.101592Antibiotic resistance patterns of community-acquired urinary tract infections caused by Enterobacterales in AlbaniaSilvi Bozo0Irida Ikonomi Hoxha1Silva Tafaj2Teuta Xhindi3Department of Chemical-Pharmaceutical and Biomolecular Technologies, Faculty of Pharmacy, Catholic University “Our Lady of Good Counsel”, Tirana, Albania; Corresponding author. Department of Chemical-Pharmaceutical and Biomolecular Technologies, Faculty of Pharmacy, Catholic University “Our Lady of Good Counsel”, Tirana, Albania.Department of Medical Technical Sciences, Aleksandër Moisiu” University, Durrës, AlbaniaMicrobiology Department, Regional Hospital Center of Tirana “Shefqet Ndroqi”, Tirana, AlbaniaDepartment of Informatics and Technology, Faculty of Engineering, Informatics and Architecture, European University of Tirana, Tirana, AlbaniaBackground: The escalating rates of antibiotic resistance, especially through Extended-Spectrum Beta-Lactamase (ESBL) production within Enterobacterales represents a critical challenge in the effective management and treatment of urinary tract infections (UTIs). This study aims to examine the distribution of pathogens, assess the prevalence of ESBL production, and analyze the resistance patterns of Enterobacterales isolated from outpatient urocultures in Albania. Methods: Midstream urine specimens from 406 patients were cultured on MacConkey agar and analyzed using the VITEK 2 automated system (bioMérieux, France). Samples with a bacterial count of ≥100,000 CFU/ml were considered positive for UTIs. Statistical analyses were conducted using SPSS software, version 27.0. Results: Among the analyzed samples, 271 (66.7 %) tested positive for UTIs. Gram-negative bacteria, particularly Enterobacterales (88.5 %) were the most common while E. coli was the predominant microorganism (87.0 %). The demographic analysis revealed that females (74.5 %) and young adults (18–34 years) (54.0 %) were the most affected groups. High resistance rates were observed for tetracycline (55.0 %), piperacillin (43.0 %), and trimethoprim (38.5 %), while resistance to meropenem was very low (1.0 %). A total of 25 isolates (12.5 %) were positive for ESBL production. Among the E. coli isolates, 12.1 % (21/174) tested positive. Statistical analysis indicated a significant association between female gender and increased antibiotic resistance. Conclusions: Our findings highlight the significant issue of antibiotic resistance in community-acquired UTIs in Albania, particularly involving Enterobacterales. Ongoing surveillance and tailored treatment strategies, alongside antibiotic stewardship programs, are crucial to address this growing public health concern.http://www.sciencedirect.com/science/article/pii/S2052297525000319Antibiotic resistanceEnterobacteralesUrinary tract infectionsESBLAlbania
spellingShingle Silvi Bozo
Irida Ikonomi Hoxha
Silva Tafaj
Teuta Xhindi
Antibiotic resistance patterns of community-acquired urinary tract infections caused by Enterobacterales in Albania
New Microbes and New Infections
Antibiotic resistance
Enterobacterales
Urinary tract infections
ESBL
Albania
title Antibiotic resistance patterns of community-acquired urinary tract infections caused by Enterobacterales in Albania
title_full Antibiotic resistance patterns of community-acquired urinary tract infections caused by Enterobacterales in Albania
title_fullStr Antibiotic resistance patterns of community-acquired urinary tract infections caused by Enterobacterales in Albania
title_full_unstemmed Antibiotic resistance patterns of community-acquired urinary tract infections caused by Enterobacterales in Albania
title_short Antibiotic resistance patterns of community-acquired urinary tract infections caused by Enterobacterales in Albania
title_sort antibiotic resistance patterns of community acquired urinary tract infections caused by enterobacterales in albania
topic Antibiotic resistance
Enterobacterales
Urinary tract infections
ESBL
Albania
url http://www.sciencedirect.com/science/article/pii/S2052297525000319
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AT iridaikonomihoxha antibioticresistancepatternsofcommunityacquiredurinarytractinfectionscausedbyenterobacteralesinalbania
AT silvatafaj antibioticresistancepatternsofcommunityacquiredurinarytractinfectionscausedbyenterobacteralesinalbania
AT teutaxhindi antibioticresistancepatternsofcommunityacquiredurinarytractinfectionscausedbyenterobacteralesinalbania