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Trimethoprim-sulfamethoxazole and fluoroquinolones Resistant Escherichia Coli in Community-Acquired and Nosocomial Urinary Tract Infections in Rio De Janeiro, Brazil
| Julio César Delgado Correal1, Lincoln de Oliveira Sant’Anna2, Ana Fátima Coelho Carvalho1, Claudia Patricia Alburquerque de Carvalho Seraphim2, Gustavo Braga Mendes1, Gabriela Higino de Souza1, Suzimar da Silveira Rioja2, Eduardo de Almeida Ribeiro Castro1, Raphael Hirata Jr2, Ana Cláudia de Paula Rosa2, Ana Luíza Mattos-Guaraldi2*, José Augusto Adler Pereira2 and Paulo Vieira Damasco1,3,4 |
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| 1State University of Rio de Janeiro, Medical Science Department, Brazil | ||
| 2State University of Rio de Janeiro, Microbiology Department, Brazil | ||
| 3Federal University of the State of Rio de Janeiro, Medicine School, UNIRIO, Brazil | ||
| 4Pedro Ernesto University Hospital, Infection Control Committee, Brazil | ||
| Corresponding Author : | Ana Luiza de Mattos Guaraldi Laboratório de Difteria e Corinebactérias de Importância Clínica-LDCIC Disciplina de Microbiologia e Imunologia, Faculdade de Ciências Médicas Universidade do Estado do Rio de Janeiro - UERJ - Av. 28 de Setembro, 87 - Fundos, 3º andar. Vila Isabel, RJ, Brazil, CEP: 20 551-030 Tel: +55(21) 2868-8280 Fax: +55(21) 2868-8376 E-mail: aguaraldi@gmail.com |
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| Received October 04, 2014; Accepted November 28, 2014; Published December 07, 2014 | ||
| Citation: Correal JCD, Sant’Anna LO, Carvalho AFC, Seraphim CPAC, Mendes GB, et al. (2014) Trimethoprim-sulfamethoxazole and fluoroquinolones Resistant Escherichia Coli in Community-Acquired and Nosocomial Urinary Tract Infections in Rio De Janeiro, Brazil. J Infect Dis Ther 2:192. doi: 10.4172/2332-0877.1000192 | ||
| Copyright: © 2014 Correal JCD, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. | ||
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Abstract
To investigate the multidrug resistance (MDR) patterns of Escherichia coli causative of urinary tract infections (UTI) in patients attending a tertiary university hospital of Rio de Janeiro, Brazil. Antibiotic susceptibility testing was performed by the disk diffusion method. MDR, extensively-resistance (XDR) and pan-resistance (PDR) were defined by using recently described criteria. Retrospective analyses of clinical, microbiological and demographic features of outpatients and inpatients with UTI (n=416) were also performed. High antibiotic resistance rates for trimethoprimsulfamethoxazole - SXT-TMP (n=177; 46.7%) and fluoroquinolones - FQ [n=117; norfloxacin (27%) and ciprofloxacin (26.8%) – (FQ) were demonstrated for E. coli strains isolated from community and healthcare-onsets. Risk factors associated with UTIs due to MDR E. coli isolates included prior three-month hospitalization (OR: 2.4; CI 95%: 1.3-4.4; p<0.005), presence of neurogenic bladder (OR: 3.7; CI 95% :1.7-8.3; p<0.01 ) and kidney transplantation (OR: 3.1; CI 95%:1-0.5; p<0.04). A high prevalence of community-acquired and nosocomial urinary tract infections due SXT-TMP/ FQ resistant E. coli strains was observed in Rio de Janeiro metropolitan area, Brazil. According to IDSA Guidelines, initial empirical therapy for community-associated UTI with SXT-TMP and FQ should be avoided in Rio de Janeiro. Nitrofurantoin, amoxicillin/clavulanic, piperacillin/tazobactam or gentamicin associations were effective for the empiric therapy for community-acquired and healthcare-associated UTIs, respectively.
