Antibiotic resistance in treating UTIs highest in aged care facilities: study

UNSW Sydney

New data on antibiotic resistance patterns in UTIs could help guide future treatment decisions.

Urinary tract infections (UTIs) caused by E. coli from aged care facilities show higher resistance to antibiotics compared to cases collected from hospitals and the wider community, find researchers from UNSW Sydney.

New research, recently published in the journal Open Forum Infectious Diseases, also found that antibiotic resistance in UTIs reduced over the course of the COVID-19 pandemic.

In Australia there have been recent reports of increasing local rates of antibiotic resistance. Associate Professor Li Zhang from UNSW’s School of Biological and Biomedical Sciences (BABS), who led the study, wanted to see how antibiotic resistance was impacting UTI treatment.

Results from this latest study provide valuable insights for medical professionals in effectively managing UTIs and for the relevant Australian authorities in formulating antibiotic treatment approaches of UTIs.

“We believe this is a really important element to be considered in the treatment of those who are affected by UTIs,” says A/Prof. Zhang.

What is a UTI?

UTIs are highly prevalent infections, with an estimated global incidence of over 400 million cases per year.

“A UTI is an infection in the urinary tract, which can be caused by a number of different bacterial types, known collectively as uropathogens,” says Ms Alex Young, a UNSW PhD candidate and co-author on the study. “The typical symptoms are frequency and urgency to urinate and pain when urinating. In a severe situation, the bacteria can travel up from the urinary tract and into the kidney, where it may transfer into blood and cause sepsis, which is very serious.”

In Australia, UTIs account for approximately 1.5 per cent of all GP consultations, equating to roughly 2.62 million GP visits a year. The standard treatment for this type of infection is an antibiotic known as trimethoprim.

“Infections are really common, but are particularly frequent in women and older people,” says Ms Young. In fact, nearly one in three women will have had at least one episode of UTI that requires antimicrobial therapy before they are 24 years old.

And like any infection that requires antibiotics, there is a risk of antibiotic resistance.

Antibiotic resistance in UTIs

Antimicrobial resistance is considered one of the most important threats to modern medicine by the World Health Organisation. In the case of UTIs, antibiotic resistance is associated with delayed symptom resolution, which can increase the chance of kidney infections.

“In each country, there are various recommended antibiotics for treating UTIs,” says A/Prof. Zhang. “Recommendations are usually based on the local antibiotic resistant pattern. And for this reason, it’s important that antibiotic resistant patterns are continuously measured and analysed.”

Recommendations on UTI management are regularly updated by various health authorities and scientific societies, and in turn, this can influence policy. For example, recent changes to UTI treatments have been made in France and the UK in response to managing changing antibiotic resistance.

Ms Young, A/Prof. Zhang and their collaborators analysed the pathogen composition and corresponding antibiotic resistance of 775,559 UTI samples from across New South Wales. These samples were collected from communities via GPs, hospitals, and aged care facilities before and during the COVID-19 pandemic.

Changing resistance patterns

/Public Release.