High Microbiological Spectrum Resistance Rates in urine isolates from Jalisco, Mexico. A retrospective study and literature review

Abstract

Background: Urinary tract infections (UTIs) are a major public health problem worldwide. In Latin America, most UTIs are treated without bacteriological identification. Our aim was to examine resistance rates to commonly prescribed antibiotics, focusing on cases from Jalisco, Mexico; and additionally to conduct a review of the literature to search for resistance patterns in other countries of Latin America. Methods: Retrospective analysis of urine cultures from ambulatory and hospitalized patients taken from Nov 2012-Nov 2013; susceptibility testing and minimal inhibitory concentration (MIC) was done by microdilution methodology. For literature search, we reviewed different data bases and included papers in English and Spanish, published from 2007-2014, representative from the Latin America region. Results: We obtained 1.206 consecutive samples from outpatient and inpatient facilities, including adult and pediatric subjects. The most frequent isolate in all groups was ESBL-producing E. coli with high resistance rates for ampicillin, TMP-SMX, and ciprofloxacin. In the literature review we found 15 papers related to resistance rates of commonly prescribed antibiotics. Conclusions: The information summarized in this article supports the finding that resistance rates to commonly prescribed antimicrobial agents are increasing worldwide. As such, this study challenges the rationale behind empiric use of antibiotics, emphasizing the need, whenever possible, to perform urine cultures before initiating antimicrobial treatment.