Urinary Tract Infections of Faial Island Community, Determined in Hospital da Horta EPER - 2016
Introduction: Urinary tract infection (UTI) is one of the most frequent infections at community level, presenting higher costs for society and health system. The publication of epidemiological evaluation studies of etiological agents responsible for UTI and its antimicrobial resistance profile is an added value for the elaboration of decision criteria for antibiotic- empirical therapy, serving as well to alert the health professionals for the benefits of a correct antimicrobial prescription.
Material and Methods: Cross-sectional epidemiological study, based on the urine cultures performed to external users of the Clinical Pathology Service of Horta Hospital EPER in the year 2016. On the urine cultures considered positive, parameters such as age, sex, type of bacteria and antimicrobial susceptibility profile were study. All records with insufficient data for analysis, as well as all requests for duplicate urine cultures from the same patient within a period of less than 7 days, were excluded from the study. All the data used were provided by the Clinical Pathology Service of the Horta Hospital EPER.
Results: Higher prevalence of positive urine cultures in women compared to men. In women, a bi-modal trend with the first peak occurring in the age group of 30 to 39 years, the second (highest) peak in the 70-79 age group. In men, the tendency to increase occurs beginning from the age group of 50 to 59; the frequency of bacteria isolated between sexes were different. The prevalence of Escherichia coli (major responsible for UTI) in women is higher than in men. The second and third most frequent bacteria were Klebsiella p. Pneumoniae and Proteus mirabilis respectively, with higher frequency in man than in woman in both cases; Major frequency of ESBL occurred in man; the study of antimicrobial profile in Escherichia coli strains showed high sensitivity to fosfomycin (>95%) and nitrofurantoin (>95%). Trimethoprim/ sulfamethoxazole and fluoroquinolones showed high resistance (close to 20%). Amoxicillin and amoxicillin/clavulanic acid with much higher resistance when compared to fosfomycin and nitrofurantoin. Excluding cephalothin, there were some heterogeneity in the cephalosporin group, but with sensitivities always higher than 80%.
Conclusion: This type of studies helps to determine the guidelines for an empirical antibiotic therapy.
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