MONITORING THE SPECTRUM OF THE URINARY TRACT MICROBIOME AND INVESTIGATING DRUG-RESISTANT FORMS AFTER THE COVID-19 PANDEMIC
Introduction. Analysis of the experienced COVID-19 pandemic, during which the use of antimicrobial drugs significantly increased, contributed to the greater spread of antibiotic resistance in the world, and led to the appearance of more "aggressive" forms of pathogens. It is imperative to...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
State Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administrative Department
2025-03-01
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| Series: | Клінічна та профілактична медицина |
| Subjects: | |
| Online Access: | https://cp-medical.com/index.php/journal/article/view/555 |
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| Summary: | Introduction. Analysis of the experienced COVID-19 pandemic, during which the use of antimicrobial drugs significantly increased, contributed to the greater spread of antibiotic resistance in the world, and led to the appearance of more "aggressive" forms of pathogens. It is imperative to study the impact of the COVID-19 pandemic on the growth of antimicrobial resistance in patients with urinary tract infections in order to improve the effectiveness of treatment.
Aim. To assess the impact of the COVID-19 pandemic on changes in the microbial landscape of urine and antibiotic resistance in patients of the Poltava region.
Materials and methods. A comparative analysis of the etiology and pathogen sensitivity in urinary tract infections was conducted on 300 patients over the period from 2018 to 2023 (Group I – 100 patients before the pandemic; Group II – 200 patients during the pandemic).
Results. Urinary tract infections complicated the course for both Group I and Group II: nephrolithiasis (51% and 45%), abnormalities of the development of the urinary system (14% and 16%), benign prostatic hyperplasia (11% and 14%), diabetes (22.5% and 25%), pregnancy (1.5%). During bacteriological examination, a combination of two or more uropathogens was detected in 14% of the Group I and in 27% of the Group II. In the first group, the urine microbiome was dominated by Enterococcus faecalis (33.3%), Escherichia coli (16.6%), Streptococcus agalactiae (11.7%), Pseudomonas aeruginosa (8.3%), Klebsiella pneumoniae (5%), and Proteus spp. (1.7%). In the Group II, there was a doubling of Escherichia coli (29.4%) and a threefold increase of Klebsiella pneumoniae (13.6%) and Proteus spp. (5.5%). A significant decrease in the sensitivity of the main uropathogens to cephalosporins, fluoroquinolones, carbapenems, and nitrofuran derivatives was observed during the COVID-19 pandemic.
Conclusions. When conducting a retrospective analysis, nephrolithiasis was the predominant cause of urinary tract infections in the reference and COVID period in both groups (51% and 45%). The frequency of urinary tract infections in diabetes has increased (25%). More than 80% of the pathogens belong to the intestinal microflora, which indicates a violation of the microbiome and bacterial translocation of uropathogens from the intestine, including due to the unreasonable use of antibiotics. Confirmation is the doubling of E. Сoli and tripling of Kl. pneumoniae in the Group II. A 2-fold increase in the combination of two or more uropathogens in the Group II (27% compared to 14%) indicates the association of pathogenic microflora in patients during the COVID-19 pandemic. Reducing the sensitivity of the main uropathogens to cephalosporins, fluoroquinolones, carbapenems and nitrofuran derivatives requires further study for more effective empiric antibiotic therapy. According to our research, the group of carbapenems should be preferred in women. |
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| ISSN: | 2616-4868 |