Um estudo sobre resistência a antimicrobianos em Escherichia coli como agente de infecção urinária: análise estatística de padrões fenotípicos observados.

Abstract

The urinary tract infections (UTI) are among the most common infectious diseases in the world, being caused, mostly, by E.coli bacteria. Over the years, antimicrobial resistance has become a problem in relation to the treatment and cure of these and other infections. The objective of this study is to analyze the pattern of bacterial resistance to antimicrobials in community and hospital environment. The study population consists of 332 observations obtained from urine cultures with isolation of E. coli to count ≥ 105 CFU / mL and information from medical records of patients. The antibiograms were performed in the laboratories of Bacteriology Pedro Ernesto University Hospital (HUPE) and the Municipal Maternity Hospital of Rio de Janeiro (HMMRJ), from May to November 2010. The statistical analysis used the highlights of excess zeros phenomenon. The proposed probabilistic model in question is to analyze the association between the number of antimicrobial to which the bacteria were resistant (outcome) and clinical and demographic explanatory variables. The results point to the importance, especially, the use of antimicrobials and previous hospitalization as risk factors for antimicrobial resistance. In the context of selective pressure, this is the first study to analyze data involving antimicrobial resistance number using a Poisson distribution inflated zeros. Finally, this study illustrates the importance of understanding these relationships as a way to contribute to the dissemination of relevant information that may assist in targeting prevention efforts and managing the impacts of changes caused by antibiotic abuse.