Estudio observacional de los urocultivos y antibiogramas realizados ambulatoriamente en un área de salud

Abstract

Background: the empirical treatment of the urine tract infection is a frequency practice in Primary Health Care. To obtain the best results we should base ourselves on the bacterial population and their sensibility to the antibiotics. Objectives: to study the bacterias responsible for the urine tract infections in the community in Almeria and their sensibility in vitro to antibiotics, like fundaments for the election of the best empirical treatment. Design: cross descriptive study. Subjets and methods: we studied all the cultures made in the year 2000 and first trimester of 2001 to inhabitants of the country of Almeria belong to the Sanitary Area of the Hospital Torrecardenas. Results: 19,546 cultures was studied. 15,551 of them were polluted or they were negative. Between 10,000 and 90,000 colonies were cultivated in 381 and in 1,673 grew 100,000 or more colonies. E. co-li was the most frequency germ (52.8%). Followed by Enterococcus faecalis in 247 samples (11.5%), Group B streptococcus in 176 (8.2%), Proteus mirabilis in 151 samples (7.0%) and Klebsiella pneumoniae in 122 (5. 7%). The most effective antibiotics in vitro in decrecent order were gentamicin, amoxicillin-clavulanate, nitrofurantoin, 3 rd generation cephalosporin and cefuroxime, with an effectiveness between 80 and 90%. Fosfomycin, ciprofloxacin and norfloxacin were effective between 65 and 70% of the cultures. Trimethroprin sulfamethoxazole and pipemidic acid had an effectiveness near to 55% and lastly ampicilina, with resistances in 65% of the cultures. Conclusions: we must revise the indication of norfloxacin and fluoroquinolone in general as best empirical treatment amoxicillin-clavulanate, nitrofurantoin, 3 rd generation cephalosporins and cefuroxime can be considered like an alternative, although these two last must be in reservation in de way of a coherent antibiotic politics.