Antimicrobial Susceptibility Patterns in Outpatient Urinary Tract Infection in the District of Coimbra, Portugal: A Cross-Sectional Study

被引:3
作者
Curto, Carolina [1 ]
Rosendo, Ines [1 ,2 ]
Santiago, Luiz [1 ,3 ,4 ]
机构
[1] Univ Coimbra, Fac Med, Coimbra, Portugal
[2] Unidade Saude Familiar Coimbra Ctr, Coimbra, Portugal
[3] Unidade Saude Familiar Topazio, Coimbra, Portugal
[4] Adm Reg Saude Ctr, Coimbra, Portugal
来源
ACTA MEDICA PORTUGUESA | 2019年 / 32卷 / 09期
关键词
Drug Resistance; Multiple; Bacterial; Portugal; Urinary Tract Infections; ESCHERICHIA-COLI; UNCOMPLICATED CYSTITIS; GENERAL-PRACTICE; PRIMARY-CARE; RESISTANCE; STEWARDSHIP; WOMEN;
D O I
10.20344/amp.10862
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction: Urinary tract infections in the community setting are quite common. It is necessary to be aware of antibiotic susceptibility patterns in order to provide rational empirical therapy. The aim of this study is to determine the frequency and antimicrobial susceptibility of the strains responsible for urinary tract infections in primary health care, in the district of Coimbra, Portugal. Material and Methods: In this observational and cross-sectional study, we analyzed 7134 positive urine cultures of outpatient laboratories in the district of Coimbra, over one year. In most cases, a positive culture was defined by a threshold of 10(5) colony-forming units per milliliter and was conducted by the automated system VITEK (R) 2, by bioMerieux. We used descriptive and inferential statistics to determine the prevalence and antimicrobial susceptibility of bacteria and to ascertain whether there were differences associated with sex and age. Results: From the total of positive cultures, 83.4% pertained to females and 41.0% to individuals over 75 years old. Escherichia coli was the most frequent strain (63.9%), although its prevalence was lower (p < 0.001) in males and individuals over 75 years old. Its susceptibility to fosfomycin and nitrofurantoin was higher than 95% and with ciprofloxacin and trimethoprim/sulfamethoxazole it was lower than 80%. Resistances were more frequent (p < 0.001) in males and in the elderly. Discussion: Escherichia coli was the most frequent strain, revealing less resistance to fosfomycin and nitrofurantoin. Antimicrobial susceptibility was lower in the elderly and in males, populations in whom empirical therapy may be less successful. Conclusion: In order to improve clinical results, we recommend periodic surveillance of antimicrobial susceptibility, which could enable the provision of efficient information to clinicians, namely those who prescribe empirically for such infections, as well as standardization of identification methods of bacterial strains diagnosis and of the antibiotic kits to be tested.
引用
收藏
页码:568 / 575
页数:8
相关论文
共 26 条
  • [1] Antimicrobial stewardship - can we afford to do without it?
    Aryee, Anna
    Price, Nicholas
    [J]. BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, 2015, 79 (02) : 173 - 181
  • [2] Betrán A, 2015, REV ESP QUIM, V28, P263
  • [3] Bonkat G., 2018, European Association of Urology
  • [4] Antimicrobial resistance surveillance in urinary tract infections in primary care
    Chin, Teh Li
    McNulty, Cliodna
    Beck, Charles
    MacGowan, Alasdair
    [J]. JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2016, 71 (10) : 2723 - 2728
  • [5] Nitrofurantoin safety and effectiveness in treating acute uncomplicated cystitis (AUC) in hospitalized adults with renal insufficiency: antibiotic stewardship implications
    Cunha, B. A.
    Cunha, C. B.
    Lam, B.
    Giuga, J.
    Chin, J.
    Zafonte, V. F.
    Gerson, S.
    [J]. EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, 2017, 36 (07) : 1213 - 1216
  • [6] Direccao Geral da Saude, 2017, PROGR PREV CONTR INF
  • [7] Antibiotics in primary care in England: which antibiotics are prescribed and for which conditions?
    Dolk, F. Christiaan K.
    Pouwels, Koen B.
    Smith, David R. M.
    Robotham, Julie V.
    Smieszek, Timo
    [J]. JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2018, 73 : 2 - 10
  • [8] European Centre for Disease Prevention and Control, 2016, EUR CTR DIS PREV CON
  • [9] Antibiotics versus placebo in the treatment of women with uncomplicated cystitis: A meta-analysis of randomized controlled trials
    Falagas, Matthew E.
    Kotsantis, Ioannis K.
    Vouloumanou, Evridiki K.
    Rafailidis, Petros I.
    [J]. JOURNAL OF INFECTION, 2009, 58 (02) : 91 - 102
  • [10] Antimicrobial susceptibility of long term care facility and general practice urine samples in patients 65 years and older: an observational study
    Fleming, Aoife
    Barry, Louise
    Byrne, Stephen
    Prentice, Michael
    [J]. EUROPEAN JOURNAL OF PUBLIC HEALTH, 2017, 27 (02) : 307 - 312