Increased resistance to first-line agents among bacterial pathogens isolated from urinary tract infections in Latin America: time for local guidelines?

Increased resistance to first-line agents among bacterial pathogens isolated from urinary tract infections in Latin America: time for local guidelines?

Autor Andrade, Soraya Sgambatti Autor UNIFESP Google Scholar
Sader, Helio Silva Autor UNIFESP Google Scholar
Jones, Ronald N Google Scholar
Pereira, Andrea dos Santos Autor UNIFESP Google Scholar
Pignatari, Antonio Carlos Campos Autor UNIFESP Google Scholar
Gales, Ana Cristina Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
JMI Laboratories
Resumo Emerging resistance phenotypes and antimicrobial resistance rates among pathogens recovered from community-acquired urinary tract infections (CA-UTI) is an increasing problem in specific regions, limiting therapeutic options. As part of the SENTRY Antimicrobial Surveillance Program, a total of 611 isolates were collected in 2003 from patients with CA-UTI presenting at Latin American medical centers. Each strain was tested in a central laboratory using Clinical Laboratory Standard Institute (CLSI) broth microdilution methods with appropriate controls. Escherichia coli was the leading pathogen (66%), followed by Klebsiella spp. (7%), Proteus mirabilis (6.4%), Enterococcus spp. (5.6%), and Pseudomonas aeruginosa (4.6%). Surprisingly high resistance rates were recorded for E. coli against first-line orally administered agents for CA-UTI, such as ampicillin (53.6%), TMP/SMX (40.4%), ciprofloxacin (21.6%), and gatifloxacin (17.1%). Decreased susceptibility rates to TMP/SMX and ciprofloxacin were also documented for Klebsiella spp. (79.1 and 81.4%, respectively), and P. mirabilis (71.8 and 84.6%, respectively). For Enterococcus spp., susceptibility rates to ampicillin, chloramphenicol, ciprofloxacin, and vancomycin were 88.2, 85.3, 55.9, and 97.1%, respectively. High-level resistance to gentamicin was detected in 24% of Enterococcus spp. Bacteria isolated from patients with CA-UTI in Latin America showed limited susceptibility to orally administered antimicrobials, especially for TMP/SMX and fluoroquinolones. Our results highlight the need for developing specific CA-UTI guidelines in geographic regions where elevated resistance to new and old compounds may influence prescribing decisions.
Assunto urinary tract infection
SENTRY
Latin America
Idioma Inglês
Data 2006-11-01
Publicado em Memórias do Instituto Oswaldo Cruz. Instituto Oswaldo Cruz, Ministério da Saúde, v. 101, n. 7, p. 741-748, 2006.
ISSN 0074-0276 (Sherpa/Romeo, fator de impacto)
Editor Instituto Oswaldo Cruz, Ministério da Saúde
Extensão 741-748
Fonte http://dx.doi.org/10.1590/S0074-02762006000700006
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000242284100006
SciELO S0074-02762006000700006 (estatísticas na SciELO)
URI http://repositorio.unifesp.br/handle/11600/3322

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