Prevalência e perfil de suscetibilidade aos antimicrobianos de Escherichia coli em uroculturas de pacientes atendidos em um hospital de ensino

• Main Author: Leonor do Nascimento, Thalia
• Publication Date: 2024
• Other Authors: Junqueira, Maria de Lourdes, Rosa Meurer, Igor, Garcia, Patricia Guedes
• Format: Article
• Language: por
• Source: HU Revista (Online)
• Download full: https://periodicos.ufjf.br/index.php/hurevista/article/view/41914
• topic: Uropathogenic Escherichia coli; Drug Resistance, Bacterial; Urine; Carbapenem-Resistant Enterobacteriaceae; Escherichia coli Uropatogênica; Farmacorresistência Bacteriana; Urina; Enterobacteriáceas Resistentes a Carbapenêmicos

Introduction: Urinary tract infections (UTI) are usually caused by bacteria of the Enterobacterales order, mainly by uropathogenic Escherichia coli (UPEC). This strain has virulence factors that make it able to colonize and infect the urinary tract. Although most cases of UTI are resolved with antimicrobial therapy, antimicrobial-resistant UPEC strains pose a serious threat to public health. Objective: To assess the prevalence of Escherichia coli in urine cultures of patients treated at a teaching hospital, as well as their antimicrobial susceptibility profile and resistance phenotypes. Material and Methods: This is a descriptive, retrospective study that analyzed urine cultures of outpatient and hospital patients treated at a teaching hospital located in the city of Juiz de Fora, Minas Gerais, Brazil from January 2020 to December 2021. Results: Among the analyzed urine cultures, 858 were positive for bacteria, with Escherichia coli being the predominant species, with 27.2% (n=233) of the isolates. Of the 858 urine cultures: 608 were from hospitalized patients, with 124 (20.4%) UPEC isolates; 250 were from outpatients, with 109 (43.6%) UPEC isolates. The antimicrobial resistance profile of the strains isolated from hospital and outpatient samples was, respectively: 65% and 32% for Ampicillin; 56% and 26% for Amoxicillin+Clavulanic acid; 50% and 26% for Ciprofloxacin; 42% and 33% for Sulfazotrim; 38% and 20% for Cefepime; 17% and 8% for Gentamicin; 2.5% and 0.4% for Ertapenem, Meropenem and Imipenem. Of the Escherichia coli strains resistant to beta-lactams, 43 (18%) showed extended-spectrum beta-lactamase (ESBL) resistance phenotypes and 7 (3%) were carbapenemases producers. Conclusion: Escherichia coli was the most isolated species from urine cultures. UPEC showed rates of resistance to all tested antimicrobials, producing ESBL and carbapenemase-like phenotypes, mainly in samples from hospitalized patients.