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determining the identification and sensitivity using the automatic MicroScan system&#44; confirming the identification by mass spectrometry &#40;MALDI TOF&#41;&#44; phenotypic confirmation using discs with specific inhibitors and the use of polymerase chain reaction for beta-lactam resistance mechanisms&#46; The results were analyzed using statistical tests &#40;SPSS method and Pearson&#39;s chi-squared test&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">A total of 4347 microorganisms were identified as causal agents &#40;3969 bacteria and 378 yeasts&#41;&#46; <span class="elsevierStyleItalic">E&#46; coli</span> was the most frequently isolated species&#44; although 62&#46;9&#37; of the UTIs were caused by other microorganisms&#46; <span class="elsevierStyleItalic">Enterococcus</span> spp&#46; was the second most common causal agent&#44; and <span class="elsevierStyleItalic">Klebsiella</span> spp&#46; and <span class="elsevierStyleItalic">P&#46; aeruginosa</span> were the third and fourth&#44; respectively&#46; It is worth mentioning that the species of the <span class="elsevierStyleItalic">Candida</span> genus represented 8&#46;7&#37; of the total of recovered isolates&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">6</span></a> The presence of multiresistant microorganisms such as <span class="elsevierStyleItalic">Acinetobacter</span> spp&#46; &#40;1&#46;2&#37;&#41;&#44; ESBL-producing enterobacteria &#40;10&#46;0&#37;&#41; and carbapenemase-producing enterobacteria &#40;0&#46;3&#37;&#41; were also relevant findings&#46; The most active antimicrobial agents were imipenem&#44; piperacillin-tazobactam and fosfomycin&#44; which presented activity rates above 80&#37;&#44; considering all studied microorganisms&#46; The rest of the antibiotics analyzed presented activity rates below 70&#37;&#44; with resistance rates greater than 40&#37; for cefuroxime&#44; ciprofloxacin and cotrimoxazole&#46; Typically&#44; the ESBL-producing strains presented a multiresistance profile that covered aminoglycosides&#44; fluoroquinolones&#44; fosfomycin and cotrimoxazole&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">7</span></a> For <span class="elsevierStyleItalic">K&#46; pneumoniae</span> but not <span class="elsevierStyleItalic">E&#46; coli</span>&#44; the 86&#37; resistance to nitrofurantoin was also significant&#46; The observed carbapenemases &#40;KPC&#44; OXA-48 and VIM&#41; were confirmed in 13 isolates&#44; which were <span class="elsevierStyleItalic">K&#46; pneumoniae</span> &#40;11&#41;&#44; <span class="elsevierStyleItalic">E&#46; coli</span><a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">1</span></a> and <span class="elsevierStyleItalic">E&#46; cloacae</span>&#44;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">1</span></a> respectively&#46; For <span class="elsevierStyleItalic">P&#46; aeruginosa</span>&#44; the sensitivity to aminoglycosides &#40;amikacin and tobramycin&#41;&#44; piperacillin-tazobactam&#44; ceftazidime and colistin was greater than 80&#37;&#46; In contrast&#44; the <span class="elsevierStyleItalic">Acinetobacter</span> spp&#46; isolates were highly resistant&#46; The isolates maintained a significant sensitivity rate against only colistin &#40;98&#37;&#41;&#46; For the Gram-positive cocci&#44; <span class="elsevierStyleItalic">Enterococcus</span> spp&#46; had a notable sensitivity &#40;greater than 80&#37;&#41; against ampicillin&#44; fosfomycin and nitrofurantoin&#46; The same rate of sensitivity was found in the staphylococci against cotrimoxazole&#44; aminoglycosides and nitrofurantoin&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The authors&#8217; conclusions mentioned that although <span class="elsevierStyleItalic">E&#46; coli</span> was the most common bacteria isolated in UTIs of hospitalized patients&#44; other bacteria represented a high percentage of various etiological agents&#46; Their resistance patterns should therefore be considered when starting an empiric antibiotic therapy&#46; Furthermore&#44; piperacillin-tazobactam&#44; imipenem and fosfomycin were the most active antibiotics&#44; which make them first-line antibiotics in the empiric treatment of UTIs in hospitalized patients&#46; For imipenem&#44; however&#44; the need to restrict the use of carbapenems makes their de-escalation essential once the sensitivity of the etiological agent of the UTI is known&#46; The use of fosfomycin-trometamol alone or in combination is recommended in the case of complicated UTIs&#46; In contrast&#44; the authors indicated that the use of amoxicillin-clavulanate&#44; cefuroxime&#44; cefotaxime&#44; ceftazidime&#44; cefepime&#44; aminoglycosides&#44; cotrimoxazole and fluoroquinolones should be limited to situations of demonstrated sensitivity but never as empiric treatment&#46; As a result&#44; the authors emphasize the need to determine the presence and type of the mechanisms responsible for the multiresistance due to the need for targeted treatment due to the limited treatment options established by these types of isolates&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">8</span></a></p></span>"
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                  "comentario" => "Available from <a class="elsevierStyleInterRef" target="_blank" id="intr0010" href="https://hws.vhebron.net/epine/Descargas/Diapositivas%20EPINE%201990-2016.pdf">https&#58;&#47;&#47;hws&#46;vhebron&#46;net&#47;epine&#47;Descargas&#47;Diapositivas&#37;20EPINE&#37;201990-2016&#46;pdf</a> &#91;accessed 23&#46;06&#46;18&#93;"
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "titulo" => "EPINE Evoluci&#243;n 1990-2016 y resumen de 2016"
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:2 [
                        "fecha" => "2016"
                        "editorial" => "Sociedad Espa&#241;ola de Medicina Preventiva&#44; Salud P&#250;blica e Higiene"
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                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nocosomial urinary tract infections"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46; Pigrau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.eimc.2012.11.015"
                      "Revista" => array:6 [
                        "tituloSerie" => "Enferm Infecc Microbiol Clin"
                        "fecha" => "2013"
                        "volumen" => "31"
                        "paginaInicial" => "614"
                        "paginaFinal" => "624"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23375744"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evolution of the resistance to antibiotics of bacteria involved in urinary tract infections&#58; a 7-year surveillance study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46; Sorl&#243;zano"
                            1 => "A&#46; Jim&#233;nez-Pacheco"
                            2 => "J&#46;D&#46; Luna del Castillo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ajic.2014.06.013"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Infect Control"
                        "fecha" => "2014"
                        "volumen" => "42"
                        "paginaInicial" => "1033"
                        "paginaFinal" => "1038"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25278389"
                            "web" => "Medline"
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                    ]
                  ]
                ]
              ]
            ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Performance standards for antimicrobial susceptibility testing&#59; twenty-six informational supplement&#46; CLSI publication M100-S26"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Clinical&#44; Laboratory Standards Institute &#40;CLSI&#41;"
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                      ]
                    ]
                  ]
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                      "Libro" => array:3 [
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                  "comentario" => "Available from <a class="elsevierStyleInterRef" target="_blank" id="intr0015" href="http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST%20files/Breakpoint%20tables/v%206.0%20Breakpoint%20table.pdf">http&#58;&#47;&#47;www&#46;eucast&#46;org&#47;fileadmin&#47;src&#47;media&#47;PDFs&#47;EUCAST files&#47;Breakpoint tables&#47;v 6&#46;0 Breakpoint table&#46;pdf</a> &#91;accessed 19&#46;04&#46;16&#93;"
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "titulo" => "Breakpoint tables for interpretation of MICs and zone diameters&#46; Version 6&#46;0"
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:2 [
                        "fecha" => "2016"
                        "editorial" => "European Committee on Antimicrobial Susceptibility Testing &#40;EUCAST&#41;"
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                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Isolated yeast species in urine samples in a Spanish regional hospital"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "V&#46; Heras-Ca&#241;as"
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                            2 => "A&#46; Sorl&#243;zano"
                            3 => "B&#46; Guti&#233;rrez-Soto"
                            4 => "J&#46;M&#46; Navarro-Mar&#237;a"
                            5 => "J&#46; Guti&#233;rrez-Fern&#225;ndez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ram.2015.07.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Argent Microbiol"
                        "fecha" => "2015"
                        "volumen" => "47"
                        "paginaInicial" => "331"
                        "paginaFinal" => "334"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26507634"
                            "web" => "Medline"
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                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "European network on carbapenemases rapid evolution and spread of carbapenemases among <span class="elsevierStyleItalic">Enterobacteriaceae</span> in Europe"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
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                            0 => "R&#46; Cant&#243;n"
                            1 => "M&#46; Ak&#243;va"
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                    ]
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                    0 => array:2 [
                      "doi" => "10.1111/j.1469-0691.2012.03821.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Microbiol Infect"
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                        "volumen" => "18"
                        "paginaInicial" => "413"
                        "paginaFinal" => "431"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22507109"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
            ]
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                    0 => array:2 [
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                      ]
                    ]
                  ]
                  "host" => array:1 [
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Editorial
Urinary tract infections and antimicrobial resistance
Infecciones del tracto urinario y resistencia antimicrobiana
M.I. Morosinia,
Corresponding author
, R. del Campob
a Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Madrid, Spain
b Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
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J.M. Sánchez-García, A. Sorlózano-Puerto, J.M. Navarro-Marí, J. Gutiérrez Fernández

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