HIGH RATES OF ANTIMICROBIAL RESISTANCE OF BACTERIA CAUSING URINARY TRACT INFECTIONS IN PATIENTS TREATED AT A TERTIARY PUBLIC HOSPITAL IN TRIÂNGULO MINEIRO, BRAZIL
DOI:
https://doi.org/10.18554/tpvf6e14Keywords:
Urinary tract infection, Bacteriuria, Multidrug resistant bacteria, Antibiotic resistanceAbstract
Urinary tract infections (UTIs) are among the most common bacterial infections acquired in the community and in hospitals. Although generally self-limiting, treatment of UTIs with antibiotics leads to a more rapid resolution of symptoms and is more likely to clear bacteriuria, but also selects for resistant uropathogens and commensal bacteria and adversely affects the individual microbiota. The aim of this study was to evaluate the prevalence and the profile of bacterial resistance of agents causing bacteriuria in patients treated at the Hospital de Clínicas of the Federal University of Triângulo Mineiro (HC-UFTM). A total of 4,358 urine samples from inpatients and outpatients were included and of these, 496 (11.4%) were positive for urine culture. Enterobacteria were the main isolated species, with Escherichia coli and Klebsiella pneumoniae identified in 262 (52.8%) and 61 (12.3%) samples, respectively. Regarding gram-positive bacteria, Enterococcus faecalis was the most prevalent (n=45; 9.1%) followed by Staphylococcus saprophyticus (n=15; 3.0%). The prevalence of ESBL-producing bacteria was 20.8% (n=81). All ESBL-positive isolates were resistant to 1st and 3rd generation cephalosporins. Furthermore, they demonstrated high rates of resistance to ciprofloxacin (84.6%), trimethoprim-sulfamethoxazole (83.9%), norfloxacin (77.2%), nitrofurantoin (41%) and gentamicin (43.1%). In relation to the gram-positive bacteria isolated, 34.8% Enterococcus spp. were resistant to gentamicin and the VRE profile was detected in 2.1%. The VRE isolate showed resistance to ampicillin, levofloxacin, gentamicin and teicoplanin. Yeasts were responsible for 7.5% of positive urine cultures, with Candida albicans being the most prevalent species (56.8%). As uropathogens are increasingly becoming resistant to currently available antibiotics, it may be time to explore alternative strategies for managing UTI.
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