Prevalência de resistência a antimicrobianos e uso de testes rápidos no diagnóstico das infecções do trato urinário adquiridas na comunidade / Prevalence of antimicrobial resistance and use of quick tests for the diagnosis of community acquired urinary tract infections
This work was divided into two studies; first to evaluate the profile of antimicrobial resistance we evaluated a consecutive sample of 411 isolates of E. coli from patients with urinary tract infection (UTI) attending an emergency unit of a private hospital from July 2008 to July 2009. The identification and antimicrobial susceptibility testing used the automated Walkaway - Microscan ® (Siemens - California). In the second study, to evaluate the performance of quick tests for diagnosis of UTI, apart from cases of UTI in the first study, we included 411 patients without UTI treated at the same place and period. The quick tests studied, direct microscopy (Gram), pyuria and nitrite were performed according to the respective protocols, quality controlmeasures were performed in all stages.
Results:
The sample consisted of 342 (83%) adults and 69 (17%) children. The gender distributionshowed that a greater number of episodes occurred in females (85%). Of 22 antibiotics tested, the highest prevalence of resistance was found for ampicillinsulbactam (41%), ampicillin (49%), cephalothin (33%) and trimethoprimsulfamethoxazole (36%), and we also noticed an unusual rate of resistance to ciprofloxacin (9%.) Forty-two percent of the isolates of E. coli were resistant to three or more drugs. There was an increase in the rate of resistance to cephalosporins, compared with a study conducted in the same city in 2001-2002. There were no significant variations in rates of resistance to most other antibiotics...