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Wiedemann B, Heisig A, Heisig P. Uncomplicated Urinary Tract Infections and Antibiotic Resistance-Epidemiological and Mechanistic Aspects. Antibiotics (Basel). 2014;3(3):341-52doi: 10.3390/antibiotics3030341.
Wiedemann, B., Heisig, A., & Heisig, P. (2014). Uncomplicated Urinary Tract Infections and Antibiotic Resistance-Epidemiological and Mechanistic Aspects. Antibiotics (Basel, Switzerland), 3(3), 341-52. https://doi.org/10.3390/antibiotics3030341
Wiedemann, Bernd, et al. "Uncomplicated Urinary Tract Infections and Antibiotic Resistance-Epidemiological and Mechanistic Aspects." Antibiotics (Basel, Switzerland) vol. 3,3 (2014): 341-52. doi: https://doi.org/10.3390/antibiotics3030341
Wiedemann B, Heisig A, Heisig P. Uncomplicated Urinary Tract Infections and Antibiotic Resistance-Epidemiological and Mechanistic Aspects. Antibiotics (Basel). 2014 Jul 22;3(3):341-52. doi: 10.3390/antibiotics3030341. PMID: 27025749; PMCID: PMC4790371.
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Antibiotics (Basel). 2014 Jul 22;3(3):341-52. doi: 10.3390/antibiotics3030341.

Uncomplicated Urinary Tract Infections and Antibiotic Resistance-Epidemiological and Mechanistic Aspects.

Antibiotics (Basel, Switzerland)

Bernd Wiedemann, Anke Heisig, Peter Heisig

Affiliations

  1. Hoi 15, 24882 Schaalby, Germany. [email protected].
  2. Pharmaceutical Biology and Microbiology, Institute of Biochemistry and Molecular Biology, University of Hamburg, Bundesstrasse 45, 20146 Hamburg, Germany. [email protected].
  3. Pharmaceutical Biology and Microbiology, Institute of Biochemistry and Molecular Biology, University of Hamburg, Bundesstrasse 45, 20146 Hamburg, Germany. [email protected].

PMID: 27025749 PMCID: PMC4790371 DOI: 10.3390/antibiotics3030341

Abstract

Uncomplicated urinary tract infections are typically monobacterial and are predominantly caused by Escherichia coli. Although several effective treatment options are available, the rates of antibiotic resistance in urinary isolates of E. coli have increased during the last decade. Knowledge of the actual local rates of antibiotic resistant pathogens as well as the underlying mechanisms are important factors in addition to the geographical location and the health state of the patient for choosing the most effective antibiotic treatment. Recommended treatment options include trimethoprim alone or in combination with sulfamethoxazol, fluoroquinolones, β-lactams, fosfomycin-trometamol, and nitrofurantoin. Three basic mechanisms of resistance to all antibiotics are known, i.e., target alteration, reduced drug concentration and inactivation of the drug. These mechanisms-alone or in combination-contribute to resistance against the different antibiotic classes. With increasing prevalence, combinations of resistance mechanisms leading to multiple drug resistant (mdr) pathogens are being detected and have been associated with reduced fitness under in vitro situations. However, mdr clones among clinical isolates such as E. coli sequence type 131 (ST131) have successfully adapted in fitness and growth rate and are rapidly spreading as a worldwide predominating clone of extraintestinal pathogenic E. coli.

Keywords: antibiotic resistance; fluoroquinolone; uUTI; β-lactam

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