| Summary: | This paper briefly reports the occurrence and epidemiology of carbapenem-resistant but cephalosporin-susceptible (Car-R/Ceph-S) <i>Pseudomonas aeruginosa</i> isolates from urinary tract infections (UTIs) in a tertiary-care hospital in the Southern Region of Hungary, and the phenotypic characterization of the possible resistance mechanisms in these isolates. Isolates and data were collected regarding <i>P. aeruginosa</i> UTIs corresponding to the period between 2008 and 2017. Susceptibility testing was performed using the Kirby–Bauer disk diffusion method; minimum inhibitory concentrations (MICs) of the isolates were determined using E-tests. The phenotypic detection of ampicillin C-type (AmpC) β-lactamases, efflux pump overexpression and carbapenemase production was also performed. <i>P. aeruginosa</i> represented <i>n</i> = 575 (2.72% ± 0.64%) from outpatient, and <i>n</i> = 1045 (5.43% ± 0.81%) from inpatient urinary samples, respectively. Based on the disk diffusion test, <i>n</i> = 359 (22.16%) were carbapenem-resistant; in addition to carbapenems, <i>n</i> = (64.34%) were also resistant to ciprofloxacin; <i>n</i> = (60.17%) to gentamicin/tobramycin; <i>n</i> = (58.51%) to levofloxacin; and <i>n</i> = (27.57%) to amikacin. From among the carbapenem-resistant isolates, <i>n</i> = 56 (15.59%) isolates were multidrug-resistant, while <i>n</i> = 16 (4.46%) were extensively drug-resistant. From among the Car-R/Ceph-S isolates (<i>n</i> = 57), overexpression of AmpC was observed in <i>n</i> = 7 cases (12.28%); carbapenemase production in <i>n</i> = 4 (7.02%); while overexpression of efflux pumps was present in <i>n</i> = 31 (54.39%) isolates. To spare last-resort agents, e.g., colistin, the use of broad-spectrum cephalosporins or safe, alternative agents should be considered in these infections.
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