Hala Kandil
West Hertfordshire Hospitals NHS Trust, UK
Title: Trends in Gram negative antimicrobial resistance and implications on Urology practice
Biography
Biography: Hala Kandil
Abstract
For many years, resistance profiles for many of the Gram-negative pathogens were relatively stable. However, the past few decades have seen a significant global upsurge in antimicrobial resistance particularly among Enterobacteriaceae. Worldwide, the prevalence of extended-spectrum β-lactamase (ESBL)–producing Enterobacteriaceae is increasing, and these organisms are frequently resistant to many other key antibiotics such as fluoroquinolones and aminoglycosides. Carbapenem-producing Gram negative bacteria are an emerging threat, leaving few treatment options. UTIs are among the most common types of infections in urology practice, with approximately 150–250 million cases globally per year. Owing to their high prevalence, UTIs are a major contributor to global antibiotic use and resistance. Increasing antimicrobial resistance represents a challenge to urologic practice and without effective antibiotics active against common uropathogens, many urologic procedures would carry excessive risk. Although new antiobiotics with activity against Gram-negative bacteria, including activity against strains with highly resistant phenotypes, are now available and some more might be available in the near future, they are likely to be used as last resort, owing to their high cost. Furthermore, it is unlikely that any single agent would be effective against the great diversity of resistance we are currently facing. This presentation will summarise the mechanisms of resistance, the current European resistance trends of Gram-negative uropathogens, examine the effect of resistance on common urology procedures, and discuss key antibiotic options in the era of resistance.