RESISTANCE TO ORAL USE ANTIBIOTICS BY URINE SAMPLES FROM NON-HOSPITALIZED PATIENTS

Abstract

The antimicrobial resistance index (RAM) grows progressively around the world. It limits the effectiveness of treating common diseases, such as urinary tract infection (UTI). In addition, currently, ADR is identified as one of the leading public health problems. Given the above, this study aimed to evaluate bacterial resistance to the most commonly used oral antibiotics for the treatment of UTI in outpatients and the identification of isolated bacteria. An experimental, observational study with a quantitative approach was carried out from January to May 2019, developed in a high-complexity private hospital located in Recife, PE. In the study, we use all positive urine cultures from adult patients treated at the hospital's outpatient clinic mentioned above were included in the study, where the MALDI – TOF (Matrix Associated Laser Desorption-Ionization – Time of Flight) equipment was used for bacterial identification. A total of 379 positive samples from urine culture samples were analyzed, of which 16 (4.2%) represented species of no clinical interest, as they obtained a very low frequency percentage, as well as 327 (86.3%) belonged to three species of bacteria Gram-negative: Escherichia coli (72.8%), Klebsiella pneumoniae (16.2%) and Proteus mirabilis (11%). While in the 36 (9.5%) samples, two Gram-positive species were identified: Staphylococcus saprophyticus (66.7%) and Enterococcus faecalis (33.3%). It was observed that the oral antibiotic with the highest percentage of resistance was sulfamethoxazole + trimethoprim with 24.5% followed by ciprofloxacin with 22.1%, cefuroxime (16.7%), amoxicillin + clavulanate (13.0%) and nitrofurantoin (8.1%). According to the recommendation, antibiotics that present resistance above 20% are excluded; thus, the only oral antibiotics that have an adequate therapeutic profile for the empirical treatment of adult UTI patients in the present study region are cefuroxime amoxicillin + clavulanate and nitrofurantoin.

Keywords: Escherichia coli. Infection. Antibiotic resistance. Urinary tract.