the prevalence of Enterobacteriaceae that produce extended-spectrum ?-lactamase or carbapenemase enzymes continues to increase at alarming rates.Bacterial resistance has major implications for urological practice, particularly in relation to catheter-associated urinary tract infections (UTIs) and infectious complications following guided biopsy of the prostate or urological surgery.Responding to the challenges of Gram-negative resistance will require a multifaceted approach including considered use of current antimicrobial agents, improved diagnostics  and surveillance, better adherence to basic measures of infection prevention, development of new antibiotics and research into non-antibiotic treatment and preventive strategies.