The impact of ESBL-producing Enterobacterales: an old story with new perspectives

Antibiotic resistance represents a global crisis, one of the biggest challenges that humanity is facing. In addition to the SARS-Cov-2 pandemic, we are currently witnessing another, more devastating pandemic of multidrug-resistant micro-organisms, not only in hospitals but also in the community. Material and methods: we aimed to analyze the incidence and implications of urinary isolated, extended-spectrum beta-lactamase-producing (ESBL+) Enterobacterales, from patients admitted between 01/01/2018 and 31/12/2018. Results: the main identified pathogen was Escherichia coli, accounting for 67.3% of all cases;the ESBL-production rate was 26.5%, with E. coli and Klebsiella pneumoniae emerging as leading etiologies. Mean age was significantly higher for patients with ESBL+ iso-lates (57.6 vs. 65.1 years, p<0.0001), while urinary catheterization was more frequently asso-ciated with ESBL+ strains (21.8% ESBL+ vs. 6.2% ESBL-, p<0.0001). As anticipated, antibi-otic susceptibility was significantly influenced both by ESBL production and urinary catheteri-zation, except for nitrofurantoin and fosfomycin. Conclusions: comprehensive approach of the local antibiotic susceptibility profile can facilitate the choice of a proper therapeutic manage-ment, based on regional particularities of an East European country.