Your browser doesn't support javascript.
loading
The global burden of antimicrobial resistance - urinary tract infections.
Von Vietinghoff, Sibylle; Shevchuk, Olga; Dobrindt, Ulrich; Engel, Daniel Robert; Jorch, Selina K; Kurts, Christian; Miethke, Thomas; Wagenlehner, Florian.
Afiliação
  • Von Vietinghoff S; University Hospital Bonn, Medical Clinic 1, Section for Nephrology and University  Bonn, Germany.
  • Shevchuk O; University Duisburg-Essen, University Hospital Essen, Institute of Experimental Immunology and Imaging, Department of Immunodynamics, Essen, Germany.
  • Dobrindt U; University of Münster, Institute of Hygiene, Münster, Germany.
  • Engel DR; University Duisburg-Essen, University Hospital Essen, Institute of Experimental Immunology and Imaging, Department of Immunodynamics, Essen, Germany.
  • Jorch SK; University Hospital Bonn and University  Bonn, Germany.
  • Kurts C; University Hospital Bonn and University  Bonn, Germany.
  • Miethke T; Medical Faculty of Mannheim University of Heidelberg, Institute for Medical Microbiology and Hygiene, Heidelberg, Germany.
  • Wagenlehner F; Medical Faculty of Mannheim, Heidelberg University, Institute for Medical Microbiology and Hygiene, Mannheim, Germany.
Nephrol Dial Transplant ; 39(4): 581-588, 2024 Mar 27.
Article em En | MEDLINE | ID: mdl-37891013
ABSTRACT
Antimicrobial resistance (AMR) has emerged as a significant global healthcare problem. Antibiotic use has accelerated the physiologic process of AMR, particularly in Gram-negative pathogens. Urinary tract infections (UTIs) are predominantly of a Gram-negative nature. Uropathogens are evolutionarily highly adapted and selected strains with specific virulence factors, suggesting common mechanisms in how bacterial cells acquire virulence and AMR factors. The simultaneous increase in resistance and virulence is a complex and context-dependent phenomenon. Among known AMR mechanisms, the plenitude of different ß-lactamases is especially prominent. The risk for AMR in UTIs varies in different patient populations. A history of antibiotic consumption and the physiology of urinary flow are major factors that shape AMR prevalence. The urinary tract is in close crosstalk with the microbiome of other compartments, including the gut and genital tracts. In addition, pharmacokinetic properties and the physiochemical composition of urinary compartments can contribute to the emergence of AMR. Alternatives to antibiotic treatment and a broader approach to address bacterial infections are needed. Among the various alternatives studied, antimicrobial peptides and bacteriophage treatment appear to be highly promising approaches. We herein summarize the present knowledge of clinical and microbiological AMR in UTIs and discuss innovative approaches, namely new risk prediction tools and the use of non-antibiotic approaches to defend against uropathogenic microbes.
Assuntos
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Sistema Urinário / Infecções Urinárias Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Sistema Urinário / Infecções Urinárias Idioma: En Ano de publicação: 2024 Tipo de documento: Article