Perfil de resistência de Enterobacteriaceae aos antimicrobianos de primeira e segunda escolha para tratamento de infecção do trato urinário de origem comunitária

Abstract

Urinary tract infection (UTI) is the second most prevalent infectious disease in the community, overtaken by respiratory infections. Objective: To analyze the resistance pattern of Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis to first and second choice antimicrobials, for oral use, for the treatment of community-acquired UTIs. Method: a cross-sectional study that analyzed positive urine cultures of outpatients, from January 2011 to December 2018, in Goiânia, Goiás, Brazil. First and second choice antimicrobials were evaluated for the treatment of urinary tract infections of community origin. Descriptive analysis was performed and the chisquare test was applied to assess the increase in the resistance pattern to the tested antimicrobials. Significance was established at p <0.05. Results: Out of 21,785 reports of urine cultures, E. coli was the most prevalent pathogen, followed by K. pneumoniae and P. mirabilis. The highest prevalence of UTI occurred in females (87.4%) and about 63.6% were aged 19 to 59. In males, the isolated ones were more resistant, except for P. mirabilis. Higher resistance patterns were identified in E. coli, K. pneumoniae, except for P. mirabilis for Trimethoprim/sulfamethoxazole (≤ 0.5%) and Levofloxacin (≤ 9.8%). Significant growth in resistance was identified in K. pneumonia for Cephalexin, E. coli for Nitrofurantoin, Trimethoprim/ Sulfamethoxazole, Cephalexin, Ciprofloxacin and Amoxacillin/Clavulanate and P. mirabilis Levofloxacin and Amoxacillin / Clavulanate