ABSTRACT
OBJECTIVE: The increase in antibiotic resistance (AR) is a global phenomenon with regional variation. This survey aims to describe the AR in urine cultures of women from the community in a southern Brazil city. METHODS: A retrospective cross-sectional single-center study in urine cultures of community dwelling individuals. The main outcome was the AR profile of bacterial isolates from women in outpatient care. RESULTS: From 4,011 urine cultures, 524 were positive (91% from women). The most frequently isolated bacteria were Escherichia coli (E. coli) (67.0%) and Klebsiella spp. (19.4%). E. coli presented low resistance to nitrofurantoin (3.7%), moderate to levofloxacin (15.6%), amoxacillin-clavulonate (16.4%) and ciprofloxacin (17.4%), and high to trimethoprim-sulfamethoxazole (26.9%). CONCLUSIONS: Nitrofurantoin seems to be the best choice for the empirical treatment of low urinary tract infections in women, whereas sulfonamides are no longer an option, since E. coli resistance to this drug is above 20%.
Subject(s)
Escherichia coli Infections , Nitrofurantoin , Brazil , Cross-Sectional Studies , Drug Resistance, Microbial , Escherichia coli , Escherichia coli Infections/drug therapy , Escherichia coli Infections/microbiology , Female , Humans , Independent Living , Microbial Sensitivity Tests , Nitrofurantoin/therapeutic use , Retrospective StudiesABSTRACT
ABSTRACT Objective The increase in antibiotic resistance (AR) is a global phenomenon with regional variation. This survey aims to describe the AR in urine cultures of women from the community in a southern Brazil city. Methods A retrospective cross-sectional single-center study in urine cultures of community dwelling individuals. The main outcome was the AR profile of bacterial isolates from women in outpatient care. Results From 4,011 urine cultures, 524 were positive (91% from women). The most frequently isolated bacteria were Escherichia coli (E. coli) (67.0%) and Klebsiella spp. (19.4%). E. coli presented low resistance to nitrofurantoin (3.7%), moderate to levofloxacin (15.6%), amoxacillin-clavulonate (16.4%) and ciprofloxacin (17.4%), and high to trimethoprim-sulfamethoxazole (26.9%). Conclusions Nitrofurantoin seems to be the best choice for the empirical treatment of low urinary tract infections in women, whereas sulfonamides are no longer an option, since E. coli resistance to this drug is above 20%.
RESUMEN Objetivo El aumento de la resistencia a los antibióticos (AR) es un fenómeno global con variaciones regionales. Esta investigación tiene como objetivo describir la AR en cultivos de orina de mujeres de la comunidad de una ciudad del sur de Brasil. Métodos Un estudio retrospectivo transversal, de un solo centro, de cultivos de orina de la comunidad. El resultado principal fue el perfil de AR de bacterias aisladas de estos cultivos de orina. Resultados De 4.011 cultivos de orina, 524 fueron positivos (91% de las mujeres). Las bacterias más frecuentemente aisladas en mujeres fueron Escherichia coli (67,0%) y Klebsiella spp. (19,4%). E. coli mostró baja resistencia a nitrofurantoína (3,7%), moderada a levofloxacina (15,6%), amoxacilina-clavulonato (16,4%) y ciprofloxacina (17,4%) y alta a trimetoprima-sulfametoxazol (26,9%) entre las mujeres. Conclusiones La nitrofurantoína parece ser la mejor opción para el tratamiento empírico de la infección de las vías urinarias inferiores en mujeres, mientras que las sulfonamidas ya no son una opción, ya que la resistencia de E. coli a este fármaco es superior al 20%.
RESUMO Objetivo O aumento da resistência aos antibióticos (AR) é um fenômeno global com variações regionais. Esta pesquisa tem como objetivo descrever a AR em culturas de urina de mulheres oriundas da comunidade em uma cidade sul-brasileira. Métodos Um estudo de centro único, transversal e retrospectivo em culturas de urina oriundas da comunidade. O principal desfecho foi o perfil de AR de bactérias isoladas de uroculturas ambulatoriais. Resultados De 4.011 culturas de urina, 524 foram positivas (91% de mulheres). As bactérias mais frequentemente isoladas em mulheres foram Escherichia coli (67,0%) e Klebsiella spp. (19,4%). E. coli apresentou baixa resistência à nitrofurantoína (3,7%), moderada a levofloxacina (15,6%), amoxacilina-clavulonato (16,4%) e ciprofloxacina (17,4%) e alta ao trimetoprim-sulfametoxazol (26,9%) entre mulheres. Conclusões A nitrofurantoína parece ser a melhor escolha para o tratamento empírico das infecções do trato urinário inferior em mulheres, enquanto as sulfonamidas não são mais uma opção, uma vez que a resistência de E. coli a essa droga é superior a 20%.
ABSTRACT
Experimental studies and registries of cases of human toxocariasis have shown that the consumption of raw or undercooked offal of the paratenic host of Toxocara canis may pose a risk of infection. Thus, we evaluated the risk of infection due to the consumption of liver of chickens inoculated with different doses of embryonated T. canis eggs. Doses were 5-100 times smaller than the ones previously employed in this type of study. Groups of five chickens were inoculated with 5000 (control), 1000, 500, 300 or 50 eggs of T. canis, and at 72 h post-inoculation, the liver of each bird was consumed by a BALB/c receptor mouse. Forty-eight hours after consumption, we examined the organs and carcasses of the mice for larvae of T. canis. All mice were positive for larvae, except the group that consumed the chicken liver inoculated with 50 eggs. This group contained only one positive mouse, in which the larva was lodged in the brain. In mice that consumed livers of chickens inoculated with ≥300 eggs, larvae concentration was primarily in the liver and lungs, characterizing the initial phase of infection. We conclude that the consumption of raw poultry liver, under the studied conditions, poses a risk of infection even with a low number of infected T. canis eggs.
