medigraphic.com
ISSN 0016-3813 (Print)

2010, Number 4

<< Back Next >>

Gac Med Mex 2010; 146 (4)

Patrones de resistencia antimicrobiana y etiología en infecciones urinarias no complicadas

Chávez-Valencia V, Gallegos-Nava S, Arce-Salinas CA

Language: Spanish
References: 33
Page: 269-273
PDF size: 112.00 Kb.


ABSTRACT

Introduction: Bacterial resistance to antibiotics is associated with morbidity, mortality, and an increase in cost. Our objective was to assess bacterial resistance from cultures of patients with noncomplicated urinary tract infection (UTI).
Methods: We analyzed antibiotic resistance using the VITEK-II system among patients attending the internal medicine unit with non-complicated UTI.
Results: 1,479 urine cultures were performed; we excluded: 98 due to contamination, 924 had no bacterial growth, and 57 had missing data. Among the 404 samples that were positive, 240 were found among out patients and 164 among hospitalized patients. E coli were the most frequent pathogen, followed by Enterococcus, and K pneumonia, in out patients; E coli, P aeruginosa, and fungal infections (23% of cases) in hospitalized patients. Samples with E coli among out patients displayed resistance of 50% to fluoroquinolones and 55% to sulfas. Among hospitalized patients, resistance was observed in 71 and 66% respectively. Resistance to P aeruginosa was 38% for amynoglucosides and carbapenems and 100% for piperacillin; Enterococcus had 50% for fluoroquinolones.
Conclusion: E. coli is the most common pathogen among UTI patients. We must adapt guidelines to recommend antibiotics and design a comprehensive control program to reduce the high levels of bacterial antibiotic resistance among our population.


REFERENCES

  1. Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Dis Mon 2003;49:53-70.

  2. Ronald AR. The etiology of urinary tract infection: traditional and emerging pathogens. Dis Mon 2002;49:71-82.

  3. Stuart ME, Macuiba J, Heidrich F, Farrell RG, Braddick M, Etchison S. Successful implementation of an evidence-based clinical practice guideline: acute dysuria/urgency in adult women. HMO Pract 1997;11:150-157.

  4. Fihn SD. Acute uncomplicated urinary tract infection in women. N Engl J Med 2003;349:259-266.

  5. Reyes MH, Díaz PH, Pastrana GS, Gil VLE, Coyoc MM, Lince FI. Guía clínica para la atención de infección no complicada de vías urinarias. Rev Med IMSS 2003;41(suppl):S91-S98.

  6. Barragán AIA, Barriga AG, Calderón FF, Casasola GJI, Francolugo VVA, Jamaica VE, et al. 1er Consenso Nacional Sobre Manejo Antimicrobiano de Infecciones de Vías Urinarias (IVUs) en el Adulto. Bol Col Mex Urol 2005;20:46- 57.

  7. Nicolle LE, Bradley S, Colgan R, Rice JC, Schaeffer A, Hooton TM. Infectious Diseases Society of America Guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis 2005;40:643– 654.

  8. Lifshitz E, Kramer L. Outpatient urine culture. Does collection technique matter? Arch Intern Med 2000;160:2537-2540.

  9. Bent S. The optimal use of diagnostic testing in women with acute uncomplicated cystitis. Dis Mon 2003;49:83-98.

  10. Cornejo JP, Velásquez AC, Sandoval S, Gordillo P, Volkow FP. Patrones de resistencia bacteriana en urocultivos en un hospital oncológico. Salud Publica Mex 2007;49:330-336.

  11. Patel HD, Livsey SA, Swann RA, Bukhari SS. Can urine dipstick testing for urinary tract infection at point of care reduce laboratory workload? J Clin Pathol 2005;58:951-954.

  12. Council of the Infectious Disease Society of America. Diagnostic standards and classification of tuberculosis in adults and children. Am J Respir Crit Care Med 2000;161:1376-1395.

  13. Nicolle LE. Urinary tract infection: traditional pharmacologic therapies. Dis Mon 2003;49:111-128.

  14. Vosti KL. Infections of the urinary tract in women: a prospective, longitudinal study of 235 women observed for 1-19 years. Medicine 2002;81:369-387.

  15. Gupta K. Addressing antibiotic resistance. Dis Mon 2003;49:99-110.

  16. Schaeffer AJ. The expanding role of fluoroquinolones. Dis Mon 2003;49:129- 147.

  17. Milo G, Katchman EA, Paul M, Christiaens T, Baerheim A, Leibovici L. Duration of antibacterial treatment for uncomplicated urinary tract infection in women. Cochrane Database Syst Rev 2005;2.

  18. Karlowsky JA, Jones ME, Thornsberry C, et al. Prevalence of antimicrobial resistance among urinary tract pathogens isolated from female outpatients across the USA in 1999. Int J Antimicrob Agents 2001;18:121-127.

  19. Ishihara S, Yokoi S, Masue N, et al. Urinary tract-derived Escherichia coli resistant to Co-trimoxazole in Japan, where the drug is seldom used for treating urinary tract infections. J Antimicrob Chemother 2002;49:881-882.

  20. Kahlmeter G. An international survey of antimicrobial susceptibility of pathogens from uncomplicated urinary tract infections: the ECHO-SENS Project. J Antimicrob Chemother 2003;51:69-76.

  21. Dias-Neto JA, Martins ACP, Dias MSL, Tiraboschi RB, Domingos ALA, Cologna AJ, et al. Community-acquired urinary tract infections: etiology and bacterial susceptibility. Acta Cir Bras 2003;18(Suppl 5):33-36.

  22. Matute AJ, Hak E, Schurink CA, McArthur A, Alonso E, Paniagua M, et al. Resistance of uropathogens in symptomatic urinary tract infections in León, Nicaragua. Int J Antimicrob Agents 2004;23:506-509.

  23. Al-Tawfiq JA. Increasing antibiotic resistance among isolates of Escherichia coli recovered from inpatients and outpatients in a Saudi Arabian hospital. Infect Control Hosp Epidemiol 2006;27:748-753.

  24. Stratchounski LS, Rafalski VV. Antimicrobial susceptibility of pathogens isolated from adult patients with uncomplicated community-acquired urinary tract infections in the Russian Federation: two multicentre studies, UTIAP 1 and UTIAP 2. Int J Antimicrob Agents 2006;28(Suppl 1):S4-S9.

  25. Akram M, Shahid M, Khan AU. Etiology and antibiotic resistance patterns of community-acquired urinary tract infections in JNMC Hospital Aligarh, India. Ann Clin Microbiol Antimicrob 2007;6:4.

  26. Keah SH, Wee EC, Chng KS, Keah KC. Antimicrobial susceptibility of community-acquired uropathogens in general practice. Mal Fam Phys 2007;2:64-69.

  27. Graham JC, Galloway A. ACP Best Practice No 167: the laboratory diagnosis of urinary tract infection. J Clin Pathol 2001;54:911-919.

  28. Pappas PG, Rex JH, Sobel JD, Filler SG, Dismukes WE, Walsh TJ, et al. Guidelines for treatment of candidiasis. Clin Infect Dis 2004;38:161-189.

  29. Brennan TA, Rothman DJ, Blank L, Blumenthal D, Chimonas SC, Cohen JJ, et al. Health industry practices that create conflicts of interest: a policy proposal for academic medical centers. JAMA 2006;295:429-433.

  30. Campbell EG. Doctors and drug companies. Scrutinizing influential relationships. N Engl J Med 2007;357:1796-1797.

  31. Hecker MT, Aron DC, Patel NP, Lehmann MK, Donskey CJ. Unnecessary use of antimicrobials in hospitalized patients: current patterns of misuse with an emphasis on the anti-anaerobic spectrum of activity. Arch Intern Med 2003;163:972-978.

  32. Paterson DL. The role of antimicrobial management programs in optimizing antibiotic prescribing within hospitals. Clin Infect Dis 2006;42(Suppl 2):S90-S95.

  33. Okeke IN, Klugman KP, Bhutta ZA, Duse AG, Jenkins P, O’Brien TF, et al. Antimicrobial resistance in developing countries. Part II: strategies for containment. Lancet Infect Dis 2005;5:568-580.




2020     |     www.medigraphic.com