---
title: "Trends in Frequency and Antimicrobial Resistance of Gram-Negative Bacilli from Urine Cultures (202"
id: "pubmed-42674579"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42674579"
content_type: "clinical_feed_article"
specialty: "Infectious Disease"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42674579/"
doi: "10.1111/apm.70257"
published_at: "2026-09-01T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Trends in Frequency and Antimicrobial Resistance of Gram-Negative Bacilli from Urine Cultures (202
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42674579
- **Specialty:** [Infectious Disease](https://medichelpline.com/clinical-feed/infectious-disease.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42674579/)
- **DOI:** [10.1111/apm.70257](https://doi.org/10.1111%2Fapm.70257)
- **Published At:** 2026-09-01T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This cross-sectional, descriptive, retrospective study analyzed 81,791 urine cultures collected between 2021 and 2025 to assess trends in frequency and antimicrobial resistance of common **Gram-negative bacilli** implicated in urinary tract infections. - Microorganism identification was performed using **MALDI Biotyper** or **MicroScan** systems; antimicrobial susceptibility testing used MicroScan and was interpreted according to **EUCAST** guidelines. - In Escherichia coli, there were statistically significant increases in resistance to amoxicillin-clavulanate, ciprofloxacin, piperacillin-tazobactam and notably **fosfomycin**, which rose from 3.48% in 2021 to 25.31% in 2025. - Klebsiella pneumoniae showed a marked rise in resistance to **fosfomycin** (from 27.25% to 79.73%) and increasing resistance to **imipenem** over the study period. - Pseudomonas aeruginosa isolates, described as predominantly hospital-acquired, had significant increases in resistance to **piperacillin-tazobactam**, **imipenem**, and antipseudomonal cephalosporins. - The authors describe the evolution of uropathogenic GNB resistance in their region as complex and dynamic, with the spread of **carbapenemases** highlighted as a particular concern. - The findings underscore the need for rigorous local epidemiological surveillance and optimization of antimicrobial stewardship programs to inform empirical treatment and infection control measures. - The study is published in APMIS (2026 Sep;134(9):e70257) and reports results relevant to both community and hospital settings; additional demographic or subgroup details were not reported in the abstract.
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Affiliations Expand ### Affiliations * 1 Microbiology Laboratory, Hospital Universitario Virgen de Las Nieves-Instituto de Investigación Biosanitaria de Granada, Granada, Spain. * 2 Clinical Medicine and Public Health Doctoral Program, Graduate School, University of Granada, Granada, Spain. * 3 Department of Internal Medicine, Hospital Universitario Virgen de Las Nieves-Instituto de Investigación Biosanitaria de Granada, Granada, Spain. * 4 Department of Microbiology, School of Medicine, University of Granada-Instituto de Investigación Biosanitaria de Granada, Granada, Spain. * PMID: **42674579** * DOI: [ 10.1111/apm.70257 ](https://doi.org/10.1111/apm.70257) Item in Clipboard # Trends in the Frequency and Antimicrobial Resistance of Common Gram-Negative Bacilli Isolated From Urine Cultures Leticia Castellano-Sánchez et al. APMIS. 2026 Sep. Show details Display options Display options Format Abstract PubMed PMID APMIS Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22APMIS%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22APMIS%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674579/) . 2026 Sep;134(9):e70257. doi: 10.1111/apm.70257. ### Authors [Leticia Castellano-Sánchez](https://pubmed.ncbi.nlm.nih.gov/?term=Castellano-S%C3%A1nchez+L&cauthor_id=42674579)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674579/#short-view-affiliation-1 "Microbiology Laboratory, Hospital Universitario Virgen de Las Nieves-Instituto de Investigación Biosanitaria de Granada, Granada, Spain.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674579/#short-view-affiliation-2 "Clinical Medicine and Public Health Doctoral Program, Graduate School, University of Granada, Granada, Spain."), [Antonio Rosales-Castillo](https://pubmed.ncbi.nlm.nih.gov/?term=Rosales-Castillo+A&cauthor_id=42674579)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674579/#short-view-affiliation-3 "Department of Internal Medicine, Hospital Universitario Virgen de Las Nieves-Instituto de Investigación Biosanitaria de Granada, Granada, Spain."), [Lucía Requena-Fernández](https://pubmed.ncbi.nlm.nih.gov/?term=Requena-Fern%C3%A1ndez+L&cauthor_id=42674579)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674579/#short-view-affiliation-1 "Microbiology Laboratory, Hospital Universitario Virgen de Las Nieves-Instituto de Investigación Biosanitaria de Granada, Granada, Spain."), [María Ramos-Bermúdez](https://pubmed.ncbi.nlm.nih.gov/?term=Ramos-Berm%C3%BAdez+M&cauthor_id=42674579)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42674579/#short-view-affiliation-4 "Department of Microbiology, School of Medicine, University of Granada-Instituto de Investigación Biosanitaria de Granada, Granada, Spain."), [Valeriano Esteban-Martín](https://pubmed.ncbi.nlm.nih.gov/?term=Esteban-Mart%C3%ADn+V&cauthor_id=42674579)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42674579/#short-view-affiliation-4 "Department of Microbiology, School of Medicine, University of Granada-Instituto de Investigación Biosanitaria de Granada, Granada, Spain."), [José Gutiérrez-Fernández](https://pubmed.ncbi.nlm.nih.gov/?term=Guti%C3%A9rrez-Fern%C3%A1ndez+J&cauthor_id=42674579)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674579/#short-view-affiliation-1 "Microbiology Laboratory, Hospital Universitario Virgen de Las Nieves-Instituto de Investigación Biosanitaria de Granada, Granada, Spain.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674579/#short-view-affiliation-2 "Clinical Medicine and Public Health Doctoral Program, Graduate School, University of Granada, Granada, Spain.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42674579/#short-view-affiliation-4 "Department of Microbiology, School of Medicine, University of Granada-Instituto de Investigación Biosanitaria de Granada, Granada, Spain.") ### Affiliations * 1 Microbiology Laboratory, Hospital Universitario Virgen de Las Nieves-Instituto de Investigación Biosanitaria de Granada, Granada, Spain. * 2 Clinical Medicine and Public Health Doctoral Program, Graduate School, University of Granada, Granada, Spain. * 3 Department of Internal Medicine, Hospital Universitario Virgen de Las Nieves-Instituto de Investigación Biosanitaria de Granada, Granada, Spain. * 4 Department of Microbiology, School of Medicine, University of Granada-Instituto de Investigación Biosanitaria de Granada, Granada, Spain. * PMID: **42674579** * DOI: [ 10.1111/apm.70257 ](https://doi.org/10.1111/apm.70257) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract The sustained increase in antimicrobial resistance among Gram-negative bacilli (GNB) compromises the effectiveness of empirical treatment regimens. This study aims to describe the evolution of the frequency and antimicrobial resistance profiles of the most commonly isolated GNB in urine cultures in our area. A cross-sectional, descriptive, and retrospective study was conducted, analyzing urine cultures from patients with suspected UTIs between 2021 and 2025. Microorganism identification was performed using MALDI Biotyper or MicroScan systems, and antimicrobial susceptibility testing was carried out using MicroScan, interpreted according to EUCAST guidelines. A total of 81,791 urine cultures were analyzed. In E. coli, a significant increase in resistance was observed for amoxicillin-clavulanate, ciprofloxacin, piperacillin-tazobactam, and fosfomycin (from 3.48% in 2021 to 25.31% in 2025). Klebsiella pneumoniae showed a marked increase in resistance to fosfomycin (from 27.25% to 79.73%) and imipenem. Pseudomonas aeruginosa, predominantly hospital-acquired, exhibited a significant increase in resistance to piperacillin-tazobactam, imipenem, and antipseudomonal cephalosporins. The evolution of antimicrobial resistance in uropathogenic GNB in our region is complex and dynamic. The spread of carbapenemases highlights the need for rigorous local epidemiological surveillance and optimization of antimicrobial stewardship programs to guide empirical therapy and infection control measures. © 2026 APMIS ‐ Journal of Pathology, Microbiology and Immunology. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## References 1. 1. Y. Zhou, Z. Zhou, L. Zheng, et al., “Urinary Tract Infections Caused by Uropathogenic Escherichia coli: Mechanisms of Infection and Treatment Options,” International Journal of Molecular Sciences 24 (2023): 10537, . 2. 1. R. Daza, J. Gutiérrez, and G. Piédrola, “Antibiotic Susceptibility of Bacterial Strains Isolated From Patients With Community‐Acquired Urinary Tract Infections,” International Journal of Antimicrobial Agents 18 (2001): 211–215, [https://doi.org/10.1016/s0924‐8579(01)00389‐2](https://doi.org/10.1016/s0924%E2%80%908579\(01\)00389%E2%80%902). 3. 1. A. Sorlozano, A. Jimenez‐Pacheco, J. de Dios Luna Del Castillo, et al., “Evolution of the Resistance to Antibiotics of Bacteria Involved in Urinary Tract Infections: A 7‐Year Surveillance Study,” American Journal of Infection Control 42, no. 10 (2014): 1033–1038, . 4. 1. European Centre for Disease Prevention and Control (ECDC), “Antimicrobial resistance in the EU/EEA (EARS‐Net)—Annual epidemiological report for 2023,” (2024). 5. 1. J. E. Cañada‐García, Z. Moure, P. J. Sola‐Campoy, et al., “CARB‐ES‐19 Multicenter Study of Carbapenemase‐Producing Klebsiella pneumoniae and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High‐Risk Clones Such as ST307/OXA‐48 and ST512/KPC‐3,” Frontiers in Microbiology 13 (2022): 918362, . Show all 25 references ## MeSH terms * Anti-Bacterial Agents* / pharmacology Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Anti-Bacterial+Agents%2Fpharmacology%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Anti-Bacterial+Agents) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674579/) * Cross-Sectional Studies Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Cross-Sectional+Studies%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Cross-Sectional+Studies) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674579/) * Drug Resistance, Bacterial* Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Drug+Resistance%2C+Bacterial%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Drug+Resistance%2C+Bacterial) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674579/) * Female Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Female%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Female) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674579/) * Gram-Negative Bacteria* / drug effects Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Gram-Negative+Bacteria%2Fdrug+effects%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Gram-Negative+Bacteria) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674579/) * Gram-Negative Bacteria* / isolation & purification Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Gram-Negative+Bacteria%2Fisolation+and+purification%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Gram-Negative+Bacteria) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674579/) * Gram-Negative Bacterial Infections* / drug therapy Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Gram-Negative+Bacterial+Infections%2Fdrug+therapy%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Gram-Negative+Bacterial+Infections) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674579/) * Gram-Negative Bacterial Infections* / epidemiology Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Gram-Negative+Bacterial+Infections%2Fepidemiology%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Gram-Negative+Bacterial+Infections) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674579/) * Gram-Negative Bacterial Infections* / microbiology Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Gram-Negative+Bacterial+Infections%2Fmicrobiology%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Gram-Negative+Bacterial+Infections) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674579/) * Humans Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Humans%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Humans) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674579/) * Male Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Male%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Male) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42
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