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2022, Number 1

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Rev Cubana Med Gen Integr 2022; 38 (1)

Cambio en la susceptibilidad de Escherichia coli y aumento de la resistencia a los antimicrobianos en infecciones del tracto urinario comunitario

Fernandes SAL, Severino PM, Silva SAC, Cardoso ML, Pereira VBNM, Rodrigues CFJ

Language: English
References: 29
Page: 1-10
PDF size: 724.09 Kb.


ABSTRACT

Introduction: Urinary tract infections caused by antibiotic-resistant Gram-negative bacteria are a growing concern due to limited therapeutic options.
Objective: To analyze the antibiotic resistance trend in ciprofloxacin-resistant Escherichia coli isolated from community-acquired urinary tract infection.
Methods: Time series study analyzing records of urine cultures positive for ciprofloxacin-resistant E. coli in persons aged ≥18 years from 2011 to 2017. The trends in antibiotic resistance patterns were obtained using the Prais-Winsten generalized linear regression. Annual percent change (APC) and 95% confidence interval (CI 95%) were calculated from the regression analysis coefficient β1 and standard error (SE). Values of p<0.05 were considered statistically significant.
Results: From the analyzed data, 3 363 (26.1%) were positive for ciprofloxacin-resistant E. coli. The increase in ciprofloxacin-resistant E. coli was 45.3%. Females suffered more infection by ciprofloxacin-sensitive E. coli (75.5%), but males had a higher chance of being infected with ciprofloxacin-resistant E. coli. [2.132 (1.891- 2.402)]. Increase in resistance was highest for nitrofurantoin (<0.001) and ceftriaxone (<0.001). Prevalence of resistance was high for nitrofurantoin, norfloxacin, nalidixic acid, amoxicillin/clavulanate, ceftriaxone, and tobramycin. Except for gentamicin, which presented a downward trend in resistance, the other antimicrobials analyzed displayed no trends in antibiotic resistance.
Conclusions: There was an average increase in resistance to the main antibiotics used to treat community-acquired UTI. Among the antibiotics tested, only gentamicin displayed a downward trend in resistance. These results are important to direct the choice of antimicrobials for the empirical treatment of community-acquired UTI.


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