Perfil antimicrobiano de cepas de Escherichia coli isolados de pessoas com suspeita de infecção do trato urinário / Antimicrobial profile of Escherichia coli strains isolated of peoples withsuspect of urinary tract infections

RESUMO

A infecção do trato urinário (ITU), situa-se entre as mais frequentes doenças bacterianas, sendo Escherichia coli um dos principais microrganismos causadores de ITU. Assim, o objetivo desse estudo foi verificar a incidência de cepas de E. coli na urina de indivíduos com suspeita de infecção urinária e avaliar o perfil de suscetibilidade a antimicrobiano dessas cepas. Foram analisadas 280 uroculturas, sendo 140 hospitalares e 140 de pessoas da comunidade, em três cidades do extremo oeste de Santa Catarina, Brasil. As urinas foram semeadas em ágar Macconkey, incubadas por 48 horas a 36 ± 1ºC. Colônias características foram identificadas por coloração de Gram e testes bioquímicos. O perfil desuscetibilidade a antimicrobianos foi realizada através da técnica de Kirby-Bauer conforme recomendações do CLSI 2005. Das 280 uroculturas analisadas, 79 (28,2%) foram positivas para Escherichia coli, destas 32 (40,5%) foram provenientes de amostras hospitalares e 47 (59,5%) de origem comunitária. O antimicrobiano de maior eficiência foi o imipenem e osantimicrobianos ampicilina, cefalotina e amicacina apresentaram maior índice de ineficácia para ambos os ambientes decoleta, demonstrando que o uso continuo e errôneo dos antimicrobianos favorecem o desenvolvimento de cepasresistentes, porque normalmente esses são drogas de primeira escolha e já não são mais eficientes nos tratamentos deITUs.

ABSTRACT

The urinary tract infection (UTI) is among the most frequent of all bacterial diseases and Escherichia coli is oneof the main microorganisms which causes the infection. Thus, the objective of this study was to verify the incidence of strains of E. coli in the individual's urine when urinary infection is suspected and to evaluate the susceptibility profile of the antimicrobials of these strains. A total of 280 urine cultures were analyzed. Half the cultures were taken from hospital patients and half were taken from people in communities located in three cities of the extreme west of Santa Catarina, Brazil. Theurine had been sown in Macconkey agar and incubated for 48 hours at 36± 1 ºC. Characteristic colonies had been identified by Gram coloration and biochemists tests. The susceptibility profile of the antimicrobials was carried through the technique in agreement with the Kirby-Bauer recommendations of CLSI 2005. Of the 280 analyzed urine cultures, 79 (28.2%) were positive for E. coli. Of these, 32 (40.5%) had come from hospital samples and 47 (59.5%) were of community-acquired origin.The antimicrobial with the most efficiency was imipenem. The ones with the worst efficiency were ampicillin, cephalothin and amikacin. This was true for cultures taken from both environments. It demonstrated that the continued and erroneous use of the antimicrobials contributed to the resistance development of strains, because these are normally drugs of first choice and already are less efficient in the treatment of ITUs.