Antimicrobial resistance of uropathogens in women with acute uncomplicated cystitis from primary care settings

Int Urol Nephrol. 2011 Jun;43(2):461-6. doi: 10.1007/s11255-010-9777-9. Epub 2010 Jun 18.

Abstract

We assessed the antimicrobial resistance patterns of all urine samples submitted for culture from outpatient women aged ≥14 years with diagnosis of uncomplicated cystitis over a 24-month period (2007-2009) in the city of Fortaleza, Brazil. Only bacterial growth of a single uropathogen with ≥10(5) CFU/mL was considered for analysis. The Pearson's chi-square test was used for bivariate correlations. Escherichia coli presented the highest prevalence (64.7%). Coagulase-negative staphylococcus was more common in younger than in older women (P = 0.003). Gentamicin presented the lowest overall resistance pattern (3.5% resistant), followed by ceftriaxone (5%) and norfloxacin (7.5%). Ampicillin and trimethoprim-sulfamethoxazole were the least active agents with 63.7% and 39.8% of resistance, respectively. The resistant rate to trimethoprim-sulfamethoxazole was significantly higher among E. coli than non-E. coli isolated. Among ciprofloxacin-resistant E. coli strains, only 3.4% were resistant to nitrofurantoin. We conclude that trimethoprim-sulfamethoxazole follows a worldwide tendency of antimicrobial increasing resistance and it should be avoided as first-line empirical treatment for urinary tract infections.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Cystitis / drug therapy*
  • Cystitis / microbiology*
  • Drug Resistance, Bacterial
  • Female
  • Humans
  • Microbial Sensitivity Tests
  • Middle Aged
  • Primary Health Care
  • Retrospective Studies
  • Urinary Tract Infections / drug therapy*
  • Urinary Tract Infections / microbiology*
  • Young Adult