At least 300 million urinary tract infections (UTIs) occur annually worldwide. Uropathogenic Escherichia coli (UPEC) are the leading cause of UTIs. The discovery of antibiotics has revolutionised modern medicine. Yet, overusing antibiotics has accelerated the emergence of antimicrobial resistance (AMR), with UPEC driving the dissemination of AMR globally. Resistance to broad-spectrum antibiotics like third-generation cephalosporins (3GCs) and fluoroquinolones threatens public health. Extended-spectrum β-lactamase (ESBL)-producing E. coli precipitate resistance, particularly when these antibiotics are used as empirical therapies against UPEC. In response, the Centers for Disease Control and Prevention in the United States have listed ESBL-producing Enterobacterales, such as E. coli as a severe threat. Additionally, the World Health Organization have classified 3GCs and fluoroquinolones as the highest priority (critically important antimicrobials), where these therapies are only recommended following susceptibility testing. The present report demonstrates the distributions of E. coli cases with resistance to 3GC and fluoroquinolones in Australia and New Zealand and contextualises trends with European reports. This investigation emphasises the value of epidemiology and the justification of evidence-based interventions using data as an essential resource for reducing resistance to our ‘first-line’ antibiotics.

全世界每年至少发生 3 亿尿路感染 (UTI)。肾盂肾炎大肠杆菌（UPEC）是领先的尿路感染的原因。抗生素的发现彻底改变了现代医学。然而，过度使用抗生素加速了抗菌素耐药性 (AMR) 的出现，UPEC 推动了 AMR 在全球的传播。对第三代头孢菌素 (3GC) 和氟喹诺酮类等广谱抗生素的耐药性威胁着公众健康。产超广谱β-内酰胺酶 (ESBL) 的大肠杆菌沉淀耐药性，特别是当这些抗生素被用作针对 UPEC 的经验疗法时。作为回应，美国疾病控制和预防中心已将产生 ESBL 的肠杆菌（如大肠杆菌）列为严重威胁。此外，世界卫生组织已将 3GC 和氟喹诺酮类药物列为最高优先级（至关重要的抗菌剂），仅在药敏试验后推荐使用这些疗法。本报告展示了大肠杆菌的分布澳大利亚和新西兰对 3GC 和氟喹诺酮类药物耐药的病例，并将趋势与欧洲报告联系起来。这项调查强调了流行病学的价值以及使用数据作为减少对我们“一线”抗生素耐药性的重要资源的循证干预措施的合理性。