Introduction: Urinary tract infection (UTI) has a high incidence and
recurrence, therefore, treatment is empirical in the majority of cases.
Objectives: The aim of this study was to analyze the urine cultures
performed at a secondary hospital, during two periods, 2005-2006 and 2010-2011, and
to estimate the microbial resistance.
Patients and methods: We analyzed 11,943 aerobic urine cultures
according to basic demographic data and susceptibility to antibiotics in accordance
with the Clinical and Laboratory Standards Institute (CLSI) for Vitek 1 and 2.
Results: Most of our cohort consisted of young adult females that were
seen at the Emergency Department. E. coli was the most frequent
(70.2%) among the 75 species isolated. Resistance of all isolates was ≥ 20% for
trimethoprim/sulfamethoxazole (TMP/SMX), norfloxacin, nitrofurantoin, cefazolin and
nalidixic acid. Although E. coli was more susceptible (resistance ≥
20% for TMP/SMX and nalidixic acid) among all of the isolates, when classified by the
number and percentage of antibiotic resistance. Global resistance to fluoroquinolones
was approximately 12%. Risk factors for E. coli were female gender
and an age less than 65 years. Men and patients older than 65 years of age, presented
more resistant isolates. Extended spectrum beta-lactamases (ESBL) were identified in
173 out of 5,722 Gram-negative isolates (3.0%) between 2010 and 2011.
Conclusion:
E. coli was the most frequent microbe isolated in the urine cultures
analyzed in this study. There was a significant evolution of bacterial resistance
between the two periods studied. In particular, the rise of bacterial resistance to
fluoroquinolones was concerning.
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