BackgroundUrinary tract infection (UTI) is one of the most common infectious diseases at the community level. In order to assess the adequacy of the empirical therapy, the prevalence and the resistance pattern of the main bacteria responsible for UTI in the community (in Aveiro, Portugal) was evaluated throughout a ten-year period.MethodsIn this retrospective study, all urine samples from patients of the District of Aveiro, in ambulatory regime, collected at the Clinical Analysis Laboratory Avelab during the period 2000–2009 were analysed. Samples with more than 105 CFU/mL bacteria were considered positive and, for these samples, the bacteria were identified and the profile of antibiotic susceptibility was characterized.ResultsFrom the 155597 samples analysed, 18797 (12.1%) were positive for bacterial infection. UTI was more frequent in women (78.5%) and its incidence varied with age, affecting more the elderly patients (38.6%). Although E. coli was, as usual, the most common pathogen implicated in UTI, it were observed differences related to the other bacteria more implicated in UTI relatively to previous studies. The bacteria implicated in the UTI varied with the sex of the patient, being P. aeruginosa a more important cause of infection in men than in women. The incidence of the main bacteria changed over the study period (P. aeruginosa, Klebsiella spp and Providencia spp increased and Enterobacter spp decreased). Although E. coli was responsible for more than an half of UTI, its resistance to antibiotics was low when compared with other pathogens implicated in UTI, showing also the lowest percentage of multidrug resistant (MDR) isolates (17%). Bacteria isolated from females were less resistant than those isolated from males and this difference increased with the patient age.ConclusionsThe differences in sex and age must be taken into account at the moment of empirical prescription of antimicrobials. From the recommended antimicrobials by the European Association of Urology guidelines, the first line drugs (pivmecillinam and nitrofurantoin) and the alternative antibiotic amoxicillin-clavulanic acid (AMX-CLA) are appropriate to treat community-acquired UTI, but the fluoroquinolones should not be suitable to treat male infections and the trimethoprim-sulfamethoxazole (SXT) shall not be used in the treatment of UTI at this level.

The aim of this study was to assess the most frequent multidrug resistant (MDR) profiles of the main bacteria implicated in community-acquired urinary tract infections (UTI). Only the MDR profiles observed in, at least, 5% of the MDR isolates were considered. A quarter of the bacteria were MDR and the most common MDR profile, including resistance to penicillins, quinolones, and sulfonamides (antibiotics with different mechanisms of action, all mainly recommended by the European Association of Urology for empirical therapy of uncomplicated UTI), was observed, alone or in association with resistance to other antimicrobial classes, in the main bacteria implicated in UTI. The penicillin class was included in all the frequent MDR profiles observed in the ten main bacteria and was the antibiotic with the highest prescription during the study period. The sulfonamides class, included in five of the six more frequent MDR profiles, was avoided between 2000 and 2009. The results suggest that the high MDR percentage and the high diversity of MDR profiles result from a high prescription of antibiotics but also from antibiotic-resistant genes transmitted with other resistance determinants on mobile genetic elements and that the UTI standard treatment guidelines must be adjusted for the community of Aveiro District.

The results of this study emphasized the relevance to consider sex as a differentiating factor in the choice of UTI empirical treatment, mainly due to differences in antimicrobial resistance. From the first line drugs recommended by the European Association of Urology (EAU) to empirical treatment of uncomplicated UTI, nitrofurantoin is the most appropriate drug for both sexes. Ciprofloxacin, although appropriate for treatment in women, is not appropriate to treat UTIs in men. From the second line drugs, both trimethoprim-sulfamethoxazole (TMP-SMX) and amoxicillin-clavulanic acid (AMX-CA) are appropriate drugs for treatment of uncomplicated UTI in women, but not as effective for men.

in the beta-pyrrolic positions; the results already obtained show that this type of PSs is also very promising.This fact, and our nding of an easy synthesis for porphyrin 1a (see Fig. 1) bearing a terpyridine unit in the beta pyrrolic position, 35 prompted us to expand the studies to the syntheses of the analogues 1b and 1c in order to use them as templates for further cationization. So, herein, we report the synthesis and the characterization of a series of neutral and cationic porphyrins bearing terpyridine units in one of their beta-pyrrolic positions. In the course of the characterization of these compounds we found that isomer differentiation of the cationic compounds could be easily achieved by ESI-MS (electrospray mass spectrometry).Additionally, their efficacy on the photoinactivation of bioluminescent E. coli was evaluated. The bioluminescent genetically transformed E. coli was selected as a model of Gramnegative bacteria to monitor in real-time photodynamic inactivation through bioluminescence measurement, thus avoiding the laborious and time-consuming conventional method of counting colony-forming units. Results and discussion Synthesis of neutral derivativesThe synthetic strategy to obtain the new b-pyrrolic cationic derivatives 6 and 7 (see Scheme 2) required the previous preparation of the corresponding neutral derivatives according with experimental work summarized in Scheme 1. The access to the new neutral porphyrins 1b and 1c bearing the terpyridine units in the b-pyrrolic positions involved the Kröhnke type approach described previously for the synthesis of porphyrin 1a. 35 In this methodology the terpyridine moiety was built directly from the easy accessible 2-formyl-5,10,15,20-porphyrin (TPP-CHO) 36 by reaction with 2-acetylpyridine (5 equiv.) in the presence of ammonium acetate (8 equiv.) and La(OTf) 3 (20 mol%).35 The procedure led to compound 1a in good yield (45%) affording as minor compounds the benzoporphyrin 2a (29%) and the porphyrin-chalcone 3a (10%) ( Table 1, entry 1).Based on that synthetic strategy we envisaged, just by changing the 2-acetylpyridine by the adequate 3-and 4-acetylpyridine the syntheses of the new neutral terpyridine derivatives 1b and 1c.In order to force the formation of the desired terpyridine 1a, the reaction was repeated in the presence of 2-acetylpyridine during 4 h. The results summarized in Table 1 (entry 2) show that the expected derivatives 1a, 2a and 3a were isolated in yields similar to our previously used conditions. However, a careful analysis of TLC data allowed us to detect a minor and more polar red product. Aer purication, the structure of this product, obtained in 4% yield, was established based on spectroscopic data (see infra and also ESI †) as the new 2-(2,4-diarylpyridin-6-yl)-5,10,15,20-tetraphenylporphyrin 4 (Fig. 2).Attempts to improve compound 4 yield by increasing the reaction time were not successful. The formation of the new derivative 4 can be explained in a similar manner as the one proposed for derivative 1a, 35 using as template...

Hepatitis A is a common viral liver disease and brings serious health and economic problems as its epidemiologic pattern changes over time. National serosurveys from developed countries have indicated a decline in HAV (hepatitis A virus) seroprevalence over time due to the improvement of economic and sanitation levels. The hepatitis A virus (HAV) immunity rate was surveyed throughout an eleven-year period by sex and age group in Aveiro District. In this retrospective study, blood samples from patients of Aveiro District, in ambulatory regime, collected at the Clinical Analysis Laboratory Avelab between 2002 and 2012 were screened for the presence of antibodies against HAV antigen using a chemiluminescence immunoassay. The global immunity (positive total anti-HAV) was 60% and only 0.3% of the patients presented recent infection by HAV (positive IgM anti-HAV). The HAV immunity was age-dependent (p < 0.05), but no significant differences (p > 0.05) between sexes were observed. The immunity was similar throughout the study period (p > 0.05). The results of this study indicate that young people (especially under 25 years old) from District of Aveiro are susceptible to HAV infection, constituting a high risk group. The elderly should be also a concern in the future of Hepatitis A infection.