Antimicrobial Resistance in Uropathogens

Urinary tract infections are among the most common infectious diseases in humans. Today, resistance to nearly all antimicrobial classes is increasing to the point that outbursts of infections carried by multidrug-resistant, extremely drug-resistant, or even pan-drug-resistant uropathogens are happening around the world. Carbapenemase-producing Enterobacteriaceae, multidrug-resistant Enterococci, and the worldwide decrease of susceptibility to fluoroquinolones in virtually all uropathogens are some among the causes of greatest concern. Careful stewardship, strict regulatory control, and usage restriction of old and new “last-resource” agents to the sole hospital setting are becoming an urgent necessity. The present chapter summarizes the general principles and mechanisms of pathogen resistance to antibacterials and focuses on the emerging worldwide threats of urological interest.