Dynamics of antibiotic resistance of the dominant gram-negative flora of the urinary tract in the adult population of the Central Federal District and Moscow

Introduction. Antibiotic resistance in gram-negative bacteria causing urinary tract infections (UTIs) poses a serious threat to healthcare and requires regular monitoring of local resistance trends. Objective. To assess the dynamics of antibiotic resistance of dominant gram-negative flora of the urogenital tract in the adult population of the Central Federal District and Moscow in 2017–2022. Materials and methods. A retrospective analysis of 34,532 urine samples from patients over 18 years of age with bacteriuria ≥105 CFU/ml was conducted. Microorganism identification was performed using MALDI-TOF MS, and sensitivity testing was performed using the disk diffusion method according to EUCAST standards. The dynamics of resistance to amikacin, gentamicin, tobramycin, ampicillin, levofloxacin, ciprofloxacin, cefepime, ceftazidime, and meropenem were studied. Results. In the period from 2017 to 2022, there was a statistically significant increase in the proportion of Escherichia coli and Klebsiella pneumoniae isolates resistant to cephalosporins, fluoroquinolones, and carbapenems. The detection rate of cephalosporin-resistant Proteus mirabilis isolates increased 3-fold in 2022 compared to 2017 (p<0.0001). The increasing resistance of urinary tract infections to cephalosporins, fluoroquinolones, and carbapenems poses a critical threat to empirical therapy. Conclusion. The growing resistance of dominant uropathogens to cephalosporins, fluoroquinolones, and carbapenems poses a critical threat to empirical UTI therapy and requires increased monitoring of the rational use of antimicrobials and increased epidemiological control.><0.0001) ). The increasing resistance of urinary tract infections to cephalosporins, fluoroquinolones, and carbapenems poses a critical threat to empirical therapy. Conclusion. The growing resistance of dominant uropathogens to cephalosporins, fluoroquinolones, and carbapenems poses a critical threat to empirical UTI therapy and requires increased monitoring of the rational use of antimicrobials and increased epidemiological control.