Padrão e evolução da resistência da Escherichia coli em infecção do trato urinário de origem comunitária

Abstract

Urinary tract infections (UTIs) are one of the most common types of infection, both community and nosocomial, and can be caused by a variety of agents. As ITU caused by bacteria are more common in both men and women and a resistance of the microorganisms to the antimicrobials most used in the fight against UTIs increase worldwide, an E. coli being the main antimicrobial involved in these infections. A retrospective and prospective descriptive study was published between 2011 and 2017. We analyzed 149,179 reports of urocultures, of which 15,255 were positive and 10,394 (68.1%) were isolated from E.coli. The mean age of women was 47.6 ± 21.6 (minimum: zero, maximum: 101 years) while in men the mean age was a little higher than 58.4 ± 18.4 (minimum: zero, maximum: 102 years). The highest prevalence of resistance to E. coli was for Ampicillin (57.7%), Ampicillin / Sulbactam (37.9%), Nalidixic Acid (35.4%), Trimetropima/Sulfamethoxazole (34.0%), Ciprofloxacin 25.9%), Amoxicillin (20.0%), Azithromycin (17.9%), Amoxicillin / Clavulanate (17.7%) and Nitrofurantoin (9.6%), with increasing trend line for all the mentioned antimicrobials Above except Ampicillin / Sulbactam which had a tendency to reduce resistance between this non-statistically significant. Regarding the growth of resistance, the significant increase without statistical test was only for Ciprofloxacin (p=0.0022). As the solution for the empirical treatment of UITs, it can be found in Nitrofurantoin, Macrolides and Amoxicillin/Clavulanate until they are known to be agents responsible for the infections and susceptibility to the antimicrobials tested, and should be replaced with a reduced spectrum antimicrobial with high potency