Prevalência e perfil de suscetibilidade aos antimicrobianos de Escherichia coli em uroculturas de pacientes atendidos em um hospital de ensino
DOI:
https://doi.org/10.34019/1982-8047.2023.v49.41914Keywords:
Uropathogenic Escherichia coli, Drug Resistance, Bacterial, Urine, Carbapenem-Resistant EnterobacteriaceaeAbstract
Introduction: Urinary tract infections (UTI) are usually caused by bacteria of the Enterobacterales order, mainly by uropathogenic Escherichia coli (UPEC). This strain has virulence factors that make it able to colonize and infect the urinary tract. Although most cases of UTI are resolved with antimicrobial therapy, antimicrobial-resistant UPEC strains pose a serious threat to public health. Objective: To assess the prevalence of Escherichia coli in urine cultures of patients treated at a teaching hospital, as well as their antimicrobial susceptibility profile and resistance phenotypes. Material and Methods: This is a descriptive, retrospective study that analyzed urine cultures of outpatient and hospital patients treated at a teaching hospital located in the city of Juiz de Fora, Minas Gerais, Brazil from January 2020 to December 2021. Results: Among the analyzed urine cultures, 858 were positive for bacteria, with Escherichia coli being the predominant species, with 27.2% (n=233) of the isolates. Of the 858 urine cultures: 608 were from hospitalized patients, with 124 (20.4%) UPEC isolates; 250 were from outpatients, with 109 (43.6%) UPEC isolates. The antimicrobial resistance profile of the strains isolated from hospital and outpatient samples was, respectively: 65% and 32% for Ampicillin; 56% and 26% for Amoxicillin+Clavulanic acid; 50% and 26% for Ciprofloxacin; 42% and 33% for Sulfazotrim; 38% and 20% for Cefepime; 17% and 8% for Gentamicin; 2.5% and 0.4% for Ertapenem, Meropenem and Imipenem. Of the Escherichia coli strains resistant to beta-lactams, 43 (18%) showed extended-spectrum beta-lactamase (ESBL) resistance phenotypes and 7 (3%) were carbapenemases producers. Conclusion: Escherichia coli was the most isolated species from urine cultures. UPEC showed rates of resistance to all tested antimicrobials, producing ESBL and carbapenemase-like phenotypes, mainly in samples from hospitalized patients.
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References
Braggiato CR, Lazar CAEL. Infecção do trato urinário não complicada na mulher: relato de caso e revisão da literatura. Revista da Faculdade de Ciências Médicas de Sorocaba. 2016; 18(4):231-4.
Santos TG. Patotipagem, tipagem filogenética, determinação de resistência aos antimicrobianos em Escherichia coli uropatogênicas [dissertação]. Jataí (GO): Programa de Pós-Graduação em Ciências Aplicadas à Saúde, Universidade Federal de Goiás, 2018.
Silva AS, Hartmann A, Staudt KJ, Alves IA. Identificação e prevalência de bactérias causadoras de infecções urinárias em nível ambulatorial. Rev Bras Pesq Saúde. 2017; 19(3):69-75. doi: 10.21722/rbps.v19i3.19569.
Foxman B. Urinary tract infection syndromes: occurrence, recurrence, bacteriology, risk factors, and disease burden. Infect Dis Clin N Am. 2014; 28(1):1-13.
Shah C, Baral R, Bartaula B, Shrestha LB. Virulence factors of uropathogenic Escherichia coli (UPEC) and correlation with antimicrobial resistance. BMC Microbiol. 2019; 19(1):204. doi: 10.1186/s12866-019-1587-3.
Bartoletti R, Cai T, Wagenlehner FM, Naber K, and Johansen TEB. Treatment of urinary tract infections and antibiotic stewardship. Eur. Urol. Suppl. 2016; 15:81-7. doi: 10.1016/j.eursup.2016.04.003
Tabasi M, Asadi Karam MR, Habibi M, Yekaninejad MS, Bouzari S. Phenotypic assays to determine virulence factors of Uropathogenic Escherichia coli (UPEC) isolates and their correlation with antibiotic resistance pattern. Osong public health and research perspectives. 2015; 6(4):261-8. doi: 10.1016/j.phrp.2015.08.002
Tille PM. Bailey & Scott’s diagnostic microbiology. 15th. ed. Elsevier; 2021.
Brazilian Committee on Antimicrobial Susceptibility Testing. Orientações do EUCAST para a detecção de mecanismos de resistência e resistências específicas de importância clínica e/ou epidemiológica [Internet]. 2018 [citado em ano mês dia]. Disponível em: http://brcast.org.br/documentos/.
Clinical Laboratory Standards Institute. performance standards for antimicrobial susceptibility testing: CLSI document M100 standard. 31th. ed. Pennsylvania: Clinical Laboratory Standards Institute; 2021.
Lacerda WC, Vale JS, Lacerda WC, Cardoso JLMS. Infecção urinária em mulheres: revisão da literatura. Saúde em Foco [Internet]. 2015 [citado em ano mês dia]; 7:282-95. Disponível em: http://www.unifia.edu.br/revista_eletronica/revistas/saude_foco/artigos/ano2015/artig o_infeccao.pdf.
Artero EA et al. Infecciones urinarias en el anciano. Urinary infection in the elderly. Rev Clin Esp. 2019; 219(4):189-93. doi: 10.1016/j.rce.2018.10.009.
Sievert DM et al. Antimicrobial-resistant pathogens associated with healthcare-associated infections: summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2009-2010. Infect Control Hosp Epidemiol. 2013; 34(1):1-14. doi: 10.1086/668770
Flores-Meireles AL et al. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015; 13(5):269-84. doi: 10.1038/nrmicro3432
Gomes AC, Carvalho PO, Lima ETA, Gomes ET, Valença MP, Cavalcanti ATA. Characterization of infections related to health care in the intensive care unit. Rev Enferm UFPE. 2014; 8(6):1577-85.
Laupland KB, Ross T, Pitout JD, Church DL, Gregson DB. Community-onset urinary tract infections: a population-based assessment. Infection. 2007; 35(3):150-3. doi: 10.1007/s15010-007-6180-2.
Magill SS, Edwards JR, Bamberg W, Beldavs ZG, Dumyati G, Kainer MA et al. Emerging infections program healthcare-associated infections and antimicrobial use prevalence survey team: multistate point-prevalence survey of health care-associated infections. N Engl J Med. 2014; 370(13):1198-208. doi: 10.1056/NEJMoa1306801.
Soto SM. Importance of biofilms in urinary tract infections: new therapeutic approaches. Advances in Biology. 2014; 1-13. doi: 10.1155/2014/543974
Costa ALP, Silva ACS. Resistência bacteriana aos antibióticos e saúde pública: uma breve revisão de literatura. Estação Científica. 2017; 7(2):45-57. doi: 10.18468/estcien.2017v7n2.p45-57
Chenoweth CE. Urinary tract infections: 2021 update. Infect Dis Clin North Am. 2021; 35(4):857-70. doi: 10.1016/j.idc.2021.08.003
Reolom RP, Klafke A. Resistência antimicrobiana em uroculturas de moradores das Zonas Norte e Nordeste de Porto Alegre. Rev Bras Med Fam Comunidade. 2022; 17(44):3067. doi: 10.5712/rbmfc17(44)3067
Lima ADP. Perfil de infecções bacterianas do trato urinário e resistência aos antibióticos [Trabalho de conclusão de curso]. Uberlândia: Universidade Federal de Uberlândia; 2017.
Chervet D et al. Antimicrobial resistance in community-acquired urinary tract infections in Paris in 2015. Med Mal Infect. 2018; 48(3):188-92. doi: 10.1016/j.medmal.2017.09.013
Kot B. Antibiotic resistance among uropathogenic Escherichia coli. Pol J Microbiol. 2019; 68(4):403-15. doi: 10.33073/pjm-2019-048.
Bartoletti R, Cai T, Wagenlehner FM, Naber K, Johansen TEB. Treatment of urinary tract infections and antibiotic stewardship. Eur Urol Suppl. 2016; 15(4):81-7. doi: 10.1016/j.eursup.2016.04.003
Warren JW, Abrutyn E, Hebel JR, Johnson JR, Schaeffer AJ, Stamm WE. Guidelines for antimicrobial treatment of uncomplicated acute bacterial cystitis and acute pyelonephritis in women. Infectious Diseases Society of America (IDSA). Clin Infect Dis. 1999; 29(4):745-58. doi: 10.1086/520427.
Prasada S, Bhat A, Bhat S, Shenoy Mulki S, Tulasidas S. Changing antibiotic susceptibility pattern in uropathogenic Escherichia coli over a period of 5 years in a tertiary care center. Infect Drug Resist. 2019; 12:1439-43. doi: 10.2147/IDR.S201849.
Lavigne JP, Bruyère F, Bernard L, Combescure C, Ronco E et al. Resistance and virulence potential of uropathogenic Escherichia coli strains isolated from patients hospitalized in urology departments: a French prospective multicentre study. J Med Microbiol. 2016; 65(6):530-7.
Shakhatreh MAK et al. Uropathogenic Escherichia coli (UPEC) in Jordan: prevalence of urovirulence genes and antibiotic resistance. Journal of King Saud University Science. 2019; 31:648-52. doi: 10.1016/j.jksus.2018.03.009
Farias DV, Castro AP, Lima WG, Paiva MC. Investigação da resistência aos betalactâmicos e da produção de betalactamase de espectro estendido (ESBL) em isolados de Escherichia coli uropatogênicas ciprofloxacina-resistente. Brazilian Journal of Health and Pharmacy. 2022; 4(1):13-26.
Thapa Shrestha U, Shrestha S, Adhikari N, Rijal KR, Shrestha B et al. Plasmid profiling and occurrence of β-lactamase enzymes in multidrug-resistant uropathogenic Escherichia coli in Kathmandu, Nepal. Infect Drug Resist. 2020; 13:1905-17. doi: 10.2147/IDR.S250591.
Millán Y, Araque M, Ramírez A. Distribución de grupos filogenéticos, factores de virulencia y susceptibilidad antimicrobiana en cepas de Escherichia coli uropatógena. Rev Chilena Infectol. 2020; 37(2):117-23. doi: 10.4067/s0716-10182020000200117
Abd El, Ghany M, Sharaf H, Al-Agamy MH, Shibl A, Hill-Cawthorne GA, Hong PY. Genomic characterization of NDM-1 and 5, and OXA-181 carbapenemases in uropathogenic Escherichia coli isolates from Riyadh, Saudi Arabia. PLoS One. 2018; 13(8):e0201613.
World Health Organization. Global antimicrobial resistance and use surveillance system (GLASS) report 2022. Geneva: 2022.
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