Revista de Epidemiologia e Controle de Infecção (Jan 2019)

Evolution of bacterial resistance in community-acquired urinary tract infection in the elderly

  • Christiano Patrício Póvoa,
  • Rodrigo Cardoso da Silva,
  • Adenicia Custódia Silva e Souza,
  • Milca Severino Pereira,
  • Kamila Cardoso dos Santos,
  • José Rodrigues do Carmo Filho

DOI
https://doi.org/10.17058/reci.v9i1.10468
Journal volume & issue
Vol. 9, no. 1

Abstract

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Background and objectives: Urinary tract infections of community origin in the elderly are frequent. The study aimed to evaluate the prevalence and evolution of resistance of gram-negative bacteria to community-acquired urinary tract infection in the elderly. Methods: Cross-sectional study, divided into two periods 2011-2012 and 2013-2015, carried out in the municipality of Goiânia, Goiás, Brazil from 2011 to 2015, with the participation of four clinical laboratories. All positive uroculture reports with the respective antibiogram were considered. Only the first report of each patient was included in the analysis, unless reinfection occurred three months after the first. Results: A total of 3,388 antibiograms were analyzed. The most frequently isolated microorganisms were successively E. coli (75.6%), K. pneumoniae, (16.6%) and Proteus spp. (5.7%). E. coli showed a high resistance rate for Sulfonamide (40.5%), Ciprofloxacin (35.0%) and increased resistance to 2nd Generation Cephalosporins (p = 0.007). The highest resistance rates in K. pneumonia were to Sulfonamide (35.2%), Nitrofurantoin (37.9%), Gemifloxacin (46.1%) and Ofloxacin (46.1%) with Increase in resistance evolution to Carbapenems (p = 0.03) and Cephalosporins of the 1st Generation (p = 0.049). For Proteus spp., the highest resistance were to Gemifloxacin (46.11%), Ofloxacin (46.11%), Nitrofurantoin (76.68%) and Levofloxacin (81.87%). Enterobacter spp., had greater resistance to Gemifloxacin (42.9%), Ofloxacin (42.9%), 1st Generation Cephalosporins (44.3%) and Levofloxacin (77.1%), with evolution of resistance to 2nd Generation Cephalosporin (p = 0.0057). Conclusion: The prevalence of bacterial resistance was high for the main antimicrobials tested and a trend was identified for the increase of resistance among the analyzed microorganisms. KEYWORDS: Bacterial Infections. Enterobacteriaceae Infections. Anti-Infective Agents. Urinary tract. Escherichia coli.