RESUMO
In order to determine the basic spectrum of urinary tract infections and their sensitivity to modern antimicrobials, the 5-year (2009-2013) study of 2621 isolates ofuropathogens from inpatients of two centers of Novosibirsk and Barnaul was carried out. Instability of proportion of the isolated microorganisms both in time and in two compared neighboring regions was found. The role of E. coli was insignificant: in Barnaul the maximum share E. coli among all uropathogens was 56.1% in 2009 (with a five-fold drop in the next year to 10.5%), Novosibirsk share of E. coli increased from 28,1% in 2009 to 49.4% in 2013, with an unaccountable fall to 33.5% in 2011. In evaluating the resistance of E. coli, many groups have shown a steady growth in antibiotic resistance. Resistance of microflora to 2nd generation cephalosporins increased by 3 times, to ciprofloxacin - by 2 times and to amoxicillin - by 7 times. However, there were virtually no strains resistant to carbapenems. Zero resistance to fosfomycin was found - all strains were susceptible to this antibiotic within 5 years. Range of UTI pathogen species in two adjacent regions was subject to significant fluctuations, no patterns were identified. In contrast, the level of microflora resistance increased. Within 5 years, it increased to basic antibiotics by 7 times, while maintaining a low resistance to nitrofurantoin, gentamicin and imipenem, and zero resistance to fosfomycin. The results of this study are consistent with international data on the partial loss of E. coli role as the leading uropathogen. Gram-positive cocci are becoming increasingly important, which is worth considering when choosing a drug for empiric therapy. Optimal antibiotics and uroseptics for treatment of patients with acute uncomplicated cystitis remain fosfomycin and nitrofurantoin, as was shown earlier.
