ABSTRACT
OBJETIVOS: Describir los patrones de resistencia bacteriana en cultivos de orina en un hospital oncológico. MATERIAL Y MÉTODOS: Se incluyeron las cepas obtenidas de cultivos de orina de 1998 a 2005. Se obtuvo el porcentaje de sensibilidad para diferentes antibióticos, tras analizar por separado cepas nosocomiales y compararlas con las de la comunidad. RESULTADOS: Se detectaron 9 232 cultivos positivos (20.7 por ciento) de 44 447 muestras: gramnegativos, 78.8 por ciento; grampositivos, 13.8 por ciento; y levaduras, 7.4 por ciento. Escherichia coli fue el principal microorganismo identificado (41.3 por ciento); la resistencia en aislados nosocomiales fue mayor que en la comunidad para amikacina (92.4 y 97 por ciento), ceftazidima (83.1 y 95.1 por ciento) y ciprofloxacina (46.2 y 58.6 por ciento). De igual manera, Pseudomonas aeruginosa presentó mayor resistencia para amikacina y ceftazidima en las cepas nosocomiales (55.7 y 66.6 por ciento; y 65.5 y 84.8 por ciento, respectivamente). Enterococcus resistente a vancomicina se encontró sólo en 2.5 por ciento (3/119 aislados de E. faecium). CONCLUSIONES: Existe una mayor resistencia bacteriana en las cepas de origen nosocomial en comparación con las cepas comunitarias. Se encontró un incremento progresivo de la resistencia para E. coli, el patógeno aislado con más frecuencia de infecciones nosocomiales y comunitarias. Es prioritario intensificar una campaña educativa para el control y uso racional de los antibióticos.
OBJECTIVE: To describe the patterns of antimicrobial resistance of organisms isolated from urine cultures at a teaching oncological hospital for adult patients. MATERIAL AND METHODS: All strains obtained from urine cultures from 1998 to 2005 were included. Mean susceptibilities were obtained for each antimicrobial tested; nosocomial and community-acquired isolates were analyzed separately. RESULTS: A total of 9 232 positive urine cultures were obtained (20.7 percent) from 44 447 samples taken. Gram negative bacteria were reported in 78.8 percent, Gram-positive in 13.8 percent and yeasts in 7.4 percent. Escherichia coli was the most frequently isolated bacterium (41.3 percent); antimicrobial resistance was higher in nosocomial isolates than in community strains (amikacin 92.4 vs. 97 percent, ceftazidime 83.1 vs. 95.1 percent and ciprofloxacin 46.2 vs. 58.6 percent). Pseudomonas aeruginosa showed a greater resistance to amikacin and ceftazidime in nosocomial cultures compared to community-acquired bacterial cultures (55.7 vs. 66.6 percent and 65.5 vs. 84.8 percent respectively). Vancomycin-resistant enterococci were found in only 2.5 percent (3 of 119 E. faecium isolates). CONCLUSIONS: Higher bacterial resistance was observed in nosocomial cultures than in community ones. Antimicrobial resistance was found to be progressively increasing for E. coli, the most frequent pathogen isolated both in nosocomial and community infections. We consider imperative the establishment of an intense educational campaign for the use and control of antibiotics.
Subject(s)
Humans , Cancer Care Facilities/statistics & numerical data , Drug Resistance, Bacterial , Drug Resistance, Fungal , Neoplasms/urine , Urine/microbiology , Bacteria/drug effects , Bacteria/isolation & purification , Bacterial Infections/epidemiology , Bacterial Infections/microbiology , Bacterial Infections/urine , Candida/drug effects , Candida/isolation & purification , Candidiasis/epidemiology , Candidiasis/microbiology , Candidiasis/urine , Community-Acquired Infections/epidemiology , Community-Acquired Infections/microbiology , Community-Acquired Infections/urine , Cross Infection/epidemiology , Cross Infection/microbiology , Cross Infection/urine , Enterococcus faecium/drug effects , Enterococcus faecium/isolation & purification , Mexico/epidemiology , Neoplasms/epidemiology , Neoplasms/microbiology , Retrospective Studies , Urinary Tract Infections/epidemiology , Urinary Tract Infections/microbiology , Urinary Tract Infections/urineABSTRACT
To investigate the risk factors and the Candida species that cause candiduria in hospitalized patients via a case-control study. We evaluated the results of the urine analysis of the specimens sent to the laboratories of Central Microbiology and the Department of Clinical Bacteriology and Infectious Diseases of Selcuk University Medical School, Konya, Turkey between January and December 2004. The urinary specimens, sent from hospitalized patients, obtained within 72 hours were evaluated. A total of 51 patients above 17 years of age, without any bacterial growth in urine specimens, with fever above 38 degrees celcius and pyuria were included in this study. A control group of 153 patients without any bacterial growth at 72 hours after hospitalization was present. The average age of the patients, the hospitalization period, and clinics resemble each other in the 2 groups. Risk for candiduria was increased by 4 folds [p=0.001; OR=4.020] in abdominal surgery, by 1.4 folds [p=0.335; OR:1.478] in corticosteroid and immune suppressive therapies and by 12 folds [p=0.000; OR=12.408] in urinary catheterization, antibiotic use increased the risk of candiduria by 6 folds [p=0.000; OR=6.00]. The risk of candiduria was higher by 2 folds in diabetes mellitus patients than in the controls [p=0.044; OR=2.002]. Candida albicans [68.62%] was the most commonly isolated agent in candiduria patients. We should decrease the use of urinary catheters and avoid excess use of antibiotics as much as possible in hospitalized patients