MP8-01 CAN WE TREAT FEMALE RECURRENT URINARY TRACT INFECTION WITHOUT URINE CULTURE? COMPARATIVE ANALYSIS OF BACTERIOLOGY AND SUSCEPTIBILITY PROFILE

Abstract

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Kidney & Bladder1 Apr 2014MP8-01 CAN WE TREAT FEMALE RECURRENT URINARY TRACT INFECTION WITHOUT URINE CULTURE? COMPARATIVE ANALYSIS OF BACTERIOLOGY AND SUSCEPTIBILITY PROFILE Marcelo Hisano, Homero Bruschini, Antonio Carlos Nicodemo, Marcos Lucon, Cristiano Mendes Gomes, Fabio Baracat, Jose Alaor de Figueiredo, and Miguel Srougi Marcelo HisanoMarcelo Hisano More articles by this author , Homero BruschiniHomero Bruschini More articles by this author , Antonio Carlos NicodemoAntonio Carlos Nicodemo More articles by this author , Marcos LuconMarcos Lucon More articles by this author , Cristiano Mendes GomesCristiano Mendes Gomes More articles by this author , Fabio BaracatFabio Baracat More articles by this author , Jose Alaor de FigueiredoJose Alaor de Figueiredo More articles by this author , and Miguel SrougiMiguel Srougi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.344AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES First uncomplicated cystitis episode (UTI) in women can be managed without urine culture. However, for recurrent uncomplicated urinary tract infection (rUTI) episodes, it is mandatory. In this study, we analyzed the bacteriology and the profile of antimicrobials susceptibility to determine if there are any reliable options to treat cystitis episode of patients with rUTI without urine culture. METHODS Between January/2007 and December/2012, we retrospectively reviewed data of 493 female patients with diagnosis of UTI and rUTI. Patients were divided in two groups: 1- patients with UTI; and 2- rUTI. Bacteriology of urine culture and susceptibility tests for nalidixic acid (NA), amoxicillin/clavulanate (AC), ampicillin (AMP), cefoxitin (CEF), ciprofloxacin(CIPR), gentamicin (GEN), levofloxacin (LEV), norfloxacin (NOR), nitrofurantoin (NITRO) and TMP-SMX were performed and compared between groups. Statistical analysis was performed with X2 or Fisher's exact test with significance of p<0.05. RESULTS Of all patients, 420 had sufficient data for analysis. Group 1 had 233 patients (55.5%), with a mean age of 39.5 years-old (y-o); group 2 had 187 patients (44.5%) and mean age of 48.6 y-o. Bacteriology of both groups was the same (table 1). Comparing groups 1 and 2, we identified a susceptibility decrease for the following antimicrobials: NA (87.7% x 65.9%); AMP (53% x 40.1%); CIPR (92.2% x 71.3%); LEV (93.1% x 72.7%); NOR (91% x 77.3%); and TMP-SMX (69% x 57.8%), all with p<0.05. No significant changes in susceptibility were found for: AC (96.0% x 90.8%); CEF (96.4% x 92.8%); GEN (96.5% x 93%); and NITRO (92% x 92.6%). Data were summarized in table 2. CONCLUSIONS Although the bacteriology was similar in groups, the antimicrobial susceptibility had differences. Actually, as nitrofurantoin and amoxicillin/clavulanate resistances were not affected by rUTI, they can be the practical choice to treat new episodes of cystitis in these patients, precluding urinary culture, since their susceptibilities rates are > 90%. Table 1. Bacteriology Group 1 Group 2 p Escherichia coli 76.4% 74.3% 0.63 Enterococcus faecalis 5.2% 8% 0.23 Staphylococcus saprophyticus 8.2% 5.9% 0.37 Proteus mirabilis 4.3% 4.3% 0.99 Klebsiella pneumoniae 3.4% 4.3% 0.65 Streptococcus agalactiae 3.5% 3.0% 0.81 Other species 6.4% 8.0% 0.53 Table 2. Antimicrobial Group 1 Group 1 Group 2 Group 2 p Susceptible(%) Resistant(%) Susceptible(%) Resistant(%) Nalidixic acid 87.7 12.3 65.9 34.1 < 0.001 Amoxicillin/clavulanate 96 4 90.8 9.2 0.07 Ampicillin 53 47 40.1 59.9 0.02 Cefoxitin 96.4 3.6 92.8 7.2 0.24 Ciprofloxacin 92.2 7.8 71.3 28.7 < 0.001 Gentamicin 96.5 3.5 93 7 0.13 Levofloxacin 93.1 6.9 72.7 27.3 < 0.001 Norfloxacin 91 9 77.3 22.7 0.03 Nitrofurantoin 92 8 92.6 7.4 0.86 TMP-SMX 69 31 57.8 42.2 0.04 © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e74-e75 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Marcelo Hisano More articles by this author Homero Bruschini More articles by this author Antonio Carlos Nicodemo More articles by this author Marcos Lucon More articles by this author Cristiano Mendes Gomes More articles by this author Fabio Baracat More articles by this author Jose Alaor de Figueiredo More articles by this author Miguel Srougi More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...