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

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dc.contributor.authorAndrade, Soraya Sgambatti [UNIFESP]
dc.contributor.authorSader, Helio Silva [UNIFESP]
dc.contributor.authorJones, Ronald N
dc.contributor.authorPereira, Andrea dos Santos [UNIFESP]
dc.contributor.authorPignatari, Antonio Carlos Campos [UNIFESP]
dc.contributor.authorGales, Ana Cristina [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionJMI Laboratories
dc.date.accessioned2015-06-14T13:36:30Z
dc.date.available2015-06-14T13:36:30Z
dc.date.issued2006-11-01
dc.description.abstractEmerging 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.en
dc.description.affiliationUniversidade Federal de São Paulo (UNIFESP) Laboratório Especial de Microbiologia Clínica
dc.description.affiliationJMI Laboratories
dc.description.affiliationUnifespUNIFESP, Laboratório Especial de Microbiologia Clínica
dc.description.sourceSciELO
dc.format.extent741-748
dc.identifierhttp://dx.doi.org/10.1590/S0074-02762006000700006
dc.identifier.citationMemórias do Instituto Oswaldo Cruz. Instituto Oswaldo Cruz, Ministério da Saúde, v. 101, n. 7, p. 741-748, 2006.
dc.identifier.doi10.1590/S0074-02762006000700006
dc.identifier.fileS0074-02762006000700006.pdf
dc.identifier.issn0074-0276
dc.identifier.scieloS0074-02762006000700006
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/3322
dc.identifier.wosWOS:000242284100006
dc.language.isoeng
dc.publisherInstituto Oswaldo Cruz, Ministério da Saúde
dc.relation.ispartofMemórias do Instituto Oswaldo Cruz
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjecturinary tract infectionen
dc.subjectSENTRYen
dc.subjectLatin Americaen
dc.titleIncreased resistance to first-line agents among bacterial pathogens isolated from urinary tract infections in Latin America: time for local guidelines?en
dc.typeinfo:eu-repo/semantics/article
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