Suscetibilidade de Escherichia coli resistente a ciprofloxacino isolada de infecção do trato urinário de origem comunitária

Abstract

Introduction: Urinary Tract Infection (UTI) is one of the most prevalent bacterial infections in adults, causing acute and chronic morbidity. The aim of the study was to analyze the epidemiological and microbiological characteristics of patients with community-based urinary tract infections caused by Ciprofloxacin-resistant E. coli in the city of Goiânia-GO from 2011 to 2017 Method: Time series study, performed from 2011 to 2017, with the participation of four clinical laboratories. All the positive urine cultures with the corresponding antibiogram were considered. Only the first report of each patient was included in the analysis, and the reinfection cases that occurred three or more months after the first one. Results: from 20,272 antibiograms evaluated, positive culture for E. coli was identified in 12,866 (65,9%) reports. Of this total 3,363 (26,1%) were resistant to Ciprofloxacin. The highest proportion of UTI occurred in females (90,1%), but higher resistance rates were identified in isolates in males (40,9%) (p<0.001), as well as the highest chance of infection was in males [2,132 (1,891-2,402)]. Higher resistance proportions with the respective resistance growth averages were, respectively, for Nalidix Acid (81,7%) and + 5,9, Norfloxacin (59,5%) and - 72,8, Amoxicillin/Clavulanate (27,1%) and + 1,4, Nitrofurantoin (26,5%) + 508,8; followed by Tobramycin (22,3%) - 61,4, Ceftriaxone (13,5%) and + 250,0. Conclusion: There was an increase in the average growth of resistance to the main antibiotics used in the treatment of community-based UTI. The proportion of resistance was high for Nitrofurantoin, Norfloxacin, Amoxacillin/Clavulanate, Cefriaxone and Tobramycin. Resistance growth trend was stable for the analyzed antimicrobials, except for the decreasing gentamicin