Revistas Fase Ing Id Materia 4028


Urinary tract infections (UTI) are among the most common entities encountered in medical practice, predominantly in women. UTI have being treated, many times, of empirical form, without a microbiological confirmation. Magalhães, V. et al.

Enteric gram-negative pathogens are responsible for most non-nosocomial uncomplicated UTIs and Escherichia coli being the most common. There is an increasing bacterial resistance to the antibiotics usually used in the treatment of UTIs around the world. However, the frequency of these pathogens and its respective resistances vary, significantly, in accordance with the geographic localization. Due to lack of research on urinary infection decrease in the region, the present study is considered to identify the etiologic profile of the UTIs and the susceptibility of these microorganisms front to antimicrobials in women older than 18 years in the city of Recife-Pernambuco. The period of the research was the understood one between November of 2006 the May of 2007. 1550 urine samples of patients with irritative voiding symptoms (dysuria, frequency, suprapubic discomfort) had been studied with urine culture (blood agar media and Teague). The positive cultures had been submitted, to a battery of biochemics tests for diagnostic confirmation, through the inoculation of the colonies in triple sugar iron media (TSI), Lysine, Indole and Ornithine. The method of the diffusion in Agar was used to evaluate the profile of sensitivity of the pathogens to antimicrobials (ampicillin, cefhalothin, gentamicin, tetracycline, sulfamethoxazole-trimethoprim, nalidixic acid, ciprofloxacin, cefoxitin, cefepime, ceftazidime, cefotaxime, amoxicillin + clavulanate, nitrofurantoin, amikacin, norfloxacin, tobramycin, ceftriaxone). Of the total of 1550 urine samples, 502 were positive for bacterial growth. The Bacteria most frequently isolated was Escherichia coli (61,2%), Klebsiella pneumoniae (12,7%) and Proteus mirabilis (7,4%), respectively. Curiously, the Staphylococcus saprophyticus was the fifth isolated agent (2,8%) in the present study, although it is considered for many authors as the second cause of cystitis in young women. We observed an important resistance of the three more isolated microorganisms to trimethoprim-sulfamethoxazole (46,6%, 29,7% and 18,9% of the cases), what it dissuades the use of the trimethoprim-sulfamethoxazole as drug of first choice for treatment of UTIs in the region. The profile of bacterial resistance to the two fluorquinolones tested, ciprofloxacin and norfloxacin, was similar, having the E. Coli a significant resistance to these two antimicrobials (20,8%). The resistance to tested antimicrobials beta-lactam was significant, having the ampicillin index of resistance of 67,1%, with exception of the cephalosporin’s, which pathogens had shown susceptibility in a great percentage of cases. We suggest that the periodic bacterial resistance study is necessary to guide the empirical treatment of UTIs in different regions.