Trimethoprim-sulfamethoxazole and fluoroquinolones Resistant Escherichia Coli in Community-Acquired and Nosocomial Urinary Tract Infections in Rio De Janeiro, Brazil

摘要: To investigate the multidrug resistance (MDR) patterns of Escherichia coli causative urinary tract infections (UTI) in patients attending a tertiary university hospital Rio de Janeiro, Brazil. Antibiotic susceptibility testing was performed by disk diffusion method. MDR, extensively-resistance (XDR) and pan-resistance (PDR) were defined using recently described criteria. Retrospective analyses clinical, microbiological demographic features outpatients inpatients with UTI (n=416) also performed. High antibiotic rates for trimethoprimsulfamethoxazole - SXT-TMP (n=177; 46.7%) fluoroquinolones FQ [n=117; norfloxacin (27%) ciprofloxacin (26.8%) – (FQ) demonstrated E. strains isolated from community healthcare-onsets. Risk factors associated UTIs due to MDR isolates included prior three-month hospitalization (OR: 2.4; CI 95%: 1.3-4.4; p<0.005), presence neurogenic bladder 3.7; 95% :1.7-8.3; p<0.01 ) kidney transplantation 3.1; 95%:1-0.5; p<0.04). A high prevalence community-acquired nosocomial SXT-TMP/ resistant observed Janeiro metropolitan area, According IDSA Guidelines, initial empirical therapy community-associated should be avoided Janeiro. Nitrofurantoin, amoxicillin/clavulanic, piperacillin/tazobactam or gentamicin associations effective empiric healthcare-associated UTIs, respectively.