Pattern Sensitivity/Resistance in the Urocultives of Patients with UT.I. who Consult Adult Urgencies, San Jose Hospital between January 2014 and December 2014

Abstract

Introduction Urinary tract infection (UTI) is a frequent cause for assistance to the emergency services, in most cases is necessary initiate empirical antimicrobial management while obtaining the result of the uroculture. Therefore, it is vital to know the pattern of sensitivity/resistance of the most frequent uropathogens and thus offer the best initial treatment. Objective To determine the pattern of sensitivity / resistance of isolated germs in the urine cultures of adults patients admitted to the emergency room with UTI suggestive symptoms. Methods An observational, descriptive, cross-sectional study was conducted, collecting urine culture data from patients diagnosed with UTI who were attended in adult emergencies in 2014. Results A total of 133 patients were analyzed (133 urine cultures), 50.4% were women, with average age of 64.1 years (SD 19.1). Higher frequency of high urinary tract infection was found (54.9%), and uncomplicated UTI (54.1%), most UTI originated in the community (95.5%). The most frequently isolated germ was E. coli (56.4%), followed by Klebsiella oxytoca (7.1%). The resistance of E. coli was 55.7% for ampicillin sulbactam, 58.2% for nitrofurantoin, 40% for quinolones and 32% for cefazolin. In patients with urological risk factors, resistance was found between 40% and 50%. BLEA pattern (12.9%), cAMP (20%) and KPC (1.4%) were evidenced. Conclusion Uropathogens have significantly increased their resistance to different families of antibiotics, including cephalosporins and quinolones, confirming that drugs such as ampicillin sulbactam, nitrofurantoin, and ciprofloxacin are not indicated in the empirical management of UTI in our institution, especially with the presence of urological risk factors.