Urological infections due to multidrug-resistant bacteria: what we need to know?

Purpose Recent epidemiological data confirm the increasing problem of antimicrobial resistance not only for hospitalized, healthcare-associated patients but also for outpatients. In particular, the progressive increase in resistance to broad-spectrum antibiotics, such as third-generation cephalosporins, fluorquinolones, or carbapenems in Enterobacteriaceae, is an alarming situation for all urologists and general practitioners. Here, we aimed to review the epidemiological data of multidrug-resistant bacteria in urological setting, in order to summarize all diagnostic and therapeutic recommendations to use in everyday clinical practice. Methods We collected all recent publications from Medline and Cochrane Library from January 2000 to December 2013. Moreover, data from the abstracts presented at the EAU and AUA Congresses during the last 5 years have also been analyzed. All papers have been evaluated by an Expert panel on Urological Infections on behalf of the Italian Urological Association (SIU). Results Fluorquinolones and other antibiotics-resistant bacteria prevalence is normally very high also in the lower urinary tract infection patients. In particular, the emerging rise of multidrug-resistant bacteria prevalence in urological practice contributes to infectious morbidity increasing with an important impact on financial costs to healthcare systems. The expert panel on Urological Infections on behalf of the Italian Urological Association formulated new diagnostic pathway and therapeutic protocol in patients affected by urological tract infections due to multidrug-resistant bacteria. Conclusions The recent emergence of multidrug-resistant pathogens is an alarming public health issue also in urological practice with socioeconomic importance. Our practice should be revised on the basis of these new acquisitions.