Abstract
The aim of this study was to assess the most frequent multidrug resistant (MDR) profiles of the main bacteria implicated in community-acquired urinary tract infections (UTI). Only the MDR profiles observed in, at least, 5% of the MDR isolates were considered. A quarter of the bacteria were MDR and the most common MDR profile, including resistance to penicillins, quinolones, and sulfonamides (antibiotics with different mechanisms of action, all mainly recommended by the European Association of Urology for empirical therapy of uncomplicated UTI), was observed, alone or in association with resistance to other antimicrobial classes, in the main bacteria implicated in UTI. The penicillin class was included in all the frequent MDR profiles observed in the ten main bacteria and was the antibiotic with the highest prescription during the study period. The sulfonamides class, included in five of the six more frequent MDR profiles, was avoided between 2000 and 2009. The results suggest that the high MDR percentage and the high diversity of MDR profiles result from a high prescription of antibiotics but also from antibiotic-resistant genes transmitted with other resistance determinants on mobile genetic elements and that the UTI standard treatment guidelines must be adjusted for the community of Aveiro District.
Highlights
Multidrug resistant (MDR) bacteria are more usually associated with nosocomial infections
Some studies performed at community level showed that MDR bacterial percentage observed among the most prevalent bacteria involved in the community-acquired urinary tract infection (UTI), Escherichia coli, varied between 38 and 54% [2, 3]
This study aimed to identify the most frequent multidrug resistance profiles of the main ten bacteria implicated in UTI acquired at the community in Aveiro District (Portugal)
Summary
Multidrug resistant (MDR) bacteria are more usually associated with nosocomial infections. Their emergence at the community level has increased, making the infections treatment more difficult, namely, the most common ones, such as the urinary tract infection (UTI). Some studies performed at community level showed that MDR bacterial percentage observed among the most prevalent bacteria involved in the community-acquired UTI, Escherichia coli, varied between 38 and 54% [2, 3]. Measures to prevent and control the increase of antimicrobial resistance as well as the dissemination of resistance genes are crucial. One of these measures is the reduction of antibiotic consumption by the implementation of norms for its rational use
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