Prevalência e perfil de sensibilidade antimicrobiana de uropatógenos comunitários e hospitalares em cidades da Amazônia Legal

Abstract

Appropriate empirical antimicrobial therapy of urinary tract infection requires knowledge about local susceptibility patterns. This study assessed the frequency and susceptibility to antimicrobials of uropathogens isolated from urine cultures from a clinical laboratory in São Luís, Maranhão, between June and November, 2015. A total of 1690 positive samples were evaluated, of which 78.8% were of community origin and 21.2% of hospital origin. The mean age of patients was 43.2 ± 26.3 years, and 73.8% were female. <i>Escherichia coli</i> was the most prevalent pathogen. Non-fermentative Gram-negative bacilli prevalence was higher among male patients and those of hospital origin. The resistance rate of community enterobacteria to ceftriaxone was 15.2% and 29.6%; to ciprofloxacin, while resistance to carbapenems and amikacin was less than 1.5%. Ceftriaxone and ciprofloxacin resistance prevalence was greater among male and elderly patients. Susceptibility of <i>Pseudomonas</i> spp. and <i>Acinetobacter</i> spp. to carbapenems was higher than 90%. Vancomycin resistant Enterococcus spp. isolates were not found among community samples. Hospital pathogens presented the worst resistance profiles; however, susceptibility to amikacin remained high in most Gram-negative bacilli tested. Especially noteworthy was the high resistance rate to ciprofloxacin among community enterobacteria. Therefore, other options must be considered for empirical therapy of urinary tract infections, especially in male and elderly patients attended in urban areas of Legal Amazon.