Structure of community-acquired urinary tract infection pathogens in the Russian Federation in 2022–2024: results of the RESOURCE-2 study

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Abstract

Aim. To analyze the structure of pathogens responsible for community-acquired urinary tract infections (UTIs) in the Russian Federation during 2022–2024.

Materials and Methods. A total of 566,122 microbiological urine samples from residents of 834 cities across 83 regions of the Russian Federation were analyzed between 2022 and 2024. The study was carried out using real-world data (RWD) analysis, based on relevant segments of the Invitro Laboratory database. Separate analyses were performed for specific types of UTIs in pregnant women, children, men, and women across various age groups.

Results. The most common UTI pathogen in Russia was Escherichia coli, detected in 40.7% of men, 69.5% of women, and 61.2% of children with community-acquired UTIs. The prevalence of E. coli was highest among women aged 38–55 years and men aged 20–50 years. The second most frequent pathogen was Klebsiella pneumoniae (12.8%), with an increasing detection rate beginning from the 38–40-year age group. Among other Enterobacterales, Proteus mirabilis was identified in 3.4% of cases. Among Gram-positive bacteria, the leading pathogens were Enterococcus faecalis (5.7%), Staphylococcus saprophyticus (1.5%), and Streptococcus agalactiae (1.8%). A significant increase in Streptococcus agalactiae detection was observed in pregnant women (6–19%) compared with non-pregnant women (2–5%) of the same age group.

Conclusions. RWD analysis represents a simple and cost-effective tool for studying the pathogen structure of community-acquired UTIs. It complements traditional microbiological surveillance methods and provides unique insights into infection etiology, including detection rates of less common uropathogens and detailed age-related variations in pathogen distribution.

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About the authors

Ekaterina M. Andreeva

Immanuel Kant Baltic Federal University

Email: v.rafalskiy@mail.ru
SPIN-code: 2252-2526

MD, PhD., doctor Clinical Pharmacologist, Clinical Research Center

Russian Federation, Kaliningrad

Alla V. Zakharova

Institute of Microbiology, Antimicrobial Therapy and Epidemiology, Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: v.rafalskiy@mail.ru

Ph.D., doctor Clinical Pharmacologist, Department of Clinical Pharmacology of Antimicrobial and Immunobiological Drugs

Russian Federation, Moscow

Alina A. Izotova

Immanuel Kant Baltic Federal University

Email: alina.tsapkova@inbox.ru
ORCID iD: 0000-0002-2701-9719
SPIN-code: 9641-9319

doctor Clinical Pharmacologist, Clinical Research Center; Postgraduate Student in Pharmacology and Clinical Pharmacology

Russian Federation, Kaliningrad

Nadezhda O. Kryukova

Immanuel Kant Baltic Federal University

Email: krukovano@yandex.ru
ORCID iD: 0000-0002-2379-6764
SPIN-code: 3938-2027

Ph.D., Associate Professor, Department of General and Clinical Pharmacology, Institute of Medicine and Life Sciences (MEDBIO)

Russian Federation, Kaliningrad

Larisa V. Mikhailova

Immanuel Kant Baltic Federal University

Email: mihalysa@mail.ru
ORCID iD: 0000-0001-5070-5955
SPIN-code: 4991-9875

Ph.D., Associate Professor, Head of the Department of Therapy, Institute of Medicine and Life Sciences (MEDBIO)

Russian Federation, Kaliningrad

Tatyana V. Priputnevich

Institute of Microbiology, Antimicrobial Therapy and Epidemiology, Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation; Russian Medical Academy of Continuous Professional Education, Ministry of Health of the Russian Federation

Email: v.rafalskiy@mail.ru
SPIN-code: 8383-7023

Corresponding Member of the Russian Academy of Sciences, Ph.D., MD, Professor, Director, Institute of Microbiology, Antimicrobial Therapy and Epidemiology, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; Head, Department of Medical Microbiology named after Academician Z.V. Ermolyeva, Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia

Russian Federation, Moscow; Moscow

Vladimir V. Rafalskiy

Immanuel Kant Baltic Federal University

Author for correspondence.
Email: v.rafalskiy@mail.ru
ORCID iD: 0000-0002-2503-9580
SPIN-code: 9424-2840

Ph.D., MD, Professor, Head of the Department of General and Clinical Pharmacology; Director, Clinical Research Center “Institute of Medicine and Life Sciences (MEDBIO)”

Russian Federation, Kaliningrad

Alexander P. Roitman

Russian Medical Academy of Continuous Professional Education, Ministry of Health of the Russian Federation

Email: v.rafalskiy@mail.ru
ORCID iD: 0000-0003-2592-6857
SPIN-code: 5400-7815

Ph.D., MD, Professor, Department of Clinical Laboratory Diagnostics  with a Course in Laboratory Immunology, Faculty of Medical Diagnostics

Russian Federation, Moscow

Natalia E. Shabanova

Institute of Microbiology, Antimicrobial Therapy and Epidemiology, Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: v.rafalskiy@mail.ru
ORCID iD: 0000-0001-6838-3616

Ph.D., MD, Associate Professor, Head of the Department of Clinical Pharmacology of Antimicrobial and Immunobiological Drugs, Institute of Microbiology, Antimicrobial Therapy and Epidemiology

Russian Federation, Moscow

Sergey V. Yakovlev

FGAOU I.M. Sechenov First Moscow State Medical University

Email: v.rafalskiy@mail.ru
SPIN-code: 9313-1453

Ph.D., MD, Professor, N.V. Sklifosovsky Institute of Clinical Medicine

Russian Federation, Moscow

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2. Fig. 1. Distribution of microbial count values ​​for the most common pathogens causing community-acquired UTIs isolated from urine. n=131101

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3. Fig. 2. Distribution of the frequencies of two pathogens isolated in the diagnostic urine titer of patients with community-acquired UTIs. The marginal sampling error for the corresponding frequencies is highlighted in gray. The total number of positive urine samples was 135,786; the number of samples with two pathogens isolated was 6,122.

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4. Fig. 3. Distribution of E. coli isolate frequencies in adult patients with community-acquired UTIs by gender and age. The marginal sampling error for the corresponding frequencies is highlighted in gray. Total number of strains analyzed: women — n=79,341, men — n=11,152

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5. Figure 4. Distribution of E. coli isolate frequencies in children with community-acquired UTIs by gender and age. The marginal sampling error for the corresponding frequencies is highlighted in gray. Total number of analyzed strains: girls - n=6599, boys - n=1824

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6. Fig. 5. Distribution of the frequencies of isolation of gram-negative "non-E. coli" pathogens in patients with community-acquired UTIs depending on age. The maximum sampling error for the corresponding frequencies is highlighted in gray. The number of K. pneumoniae strains studied was 17,000, and P. mirabilis strains were 4,518.

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7. Fig. 6. Distribution of the frequencies of Gram(+) pathogens isolated from patients with community-acquired UTIs depending on age. The maximum sampling error for the corresponding frequencies is highlighted in gray. Number of strains studied: E. faecalis - 9049, S. saprophyticus - 2109

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8. Fig. 7. Distribution of S. agalactiae isolate frequencies in patients with community-acquired UTIs by gender, age, and pregnancy status. The total number of strains analyzed was 2985: 2803 in non-pregnant women, 182 in men, and 318 in pregnant women.

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