| Congresso Brasileiro de Microbiologia 2023 | Resumo: 598-1 | ||||
Resumo:Urinary tract infections (UTI) are one of the most prevalent community pathologies worldwide, which are often treated empirically. However, the success of the treatment depends on the resistance profile of the etiologic agents, which needs to be monitored periodically. This study aimed to trace the etiological and antimicrobial resistance profiles of positive urine cultures of outpatients obtained by a clinical analysis laboratory that serves the immediate region of Carangola-MG (approximately 112,460 inhabitants). This was an observational, descriptive cross-sectional study, which included positive urine cultures with antibiogram results. During the first semester of 2021, the laboratory issued 2,703 clinical reports of urine cultures and, of these, 554 (20.5%) had a positive diagnosis for UTI. Females accounted for 483 (87.2%) of the positive urine cultures, while 71 (12.8%) were from males. Gram-negative bacilli of the Enterobacteriaceae family were the most frequent etiological agents, being identified in 498 (89.9%) of the positive urine cultures. Escherichia coli was the most frequently identified pathogen, followed by Proteus sp., Klebsiella sp. and Enterobacter sp. Gram-positive cocci were identified as the etiological agents of 56 (10.1%) positive urine cultures, with predominance of Enterococcus sp., followed by Staphylococcus sp., Streptococcus sp. and Staphylococcus aureus. The antimicrobials to which the gram-positive uropathogens showed the highest rates of resistance were erythromycin, tetracycline, ampicillin, penicillin, sulfa/trimethoprim and oxacillin. Among the gram-negatives, the most common resistances were to ampicillin, tetracycline, cephalothin, nalidixic acid, sulfa/trimethoprim and cefazolin. We observed that 261 (47.1%) uropathogens, had the multidrug-resistant (MDR) phenotype. The number of MDR uropathogens was positively correlated with the age of the patients. The high rates of resistance to ampicillin, tetracycline, cephalothin, nalidixic acid, and sulfamethoxazole-trimethoprim observed here highlight the need to review the empirical use of these drugs in the treatment of community UTI in this region. Understanding the prevalence of etiological agents and their respective resistance profiles will allow the optimization of the empirical treatment of UTI. In view of the accelerated emergence of MDR uropathogens, the most prudent path is to start antimicrobial treatment only after analyzing the antibiogram.
Development Agency: not applicable Palavras-chave: Community Acquired Urinary Tract Infecti, Multidrug-Resistant, Uropathogens Agência de fomento:not applicable | |||||