Periodicidad semestral: flujo continuo.
ISSN - Electrónico: 2661-6947 / DOI: 10.36015 • LILACS BIREME (19784); LATINDEX (20666)
INTRODUCTION. Urinary tract infections due to a variety of multi-resistant uropathogenic bacteria are due to the use of empirical treatment or self-medication. OBJECTIVE. Describe diagnostic methods, empirical treatment and multidrug resistance in urinary tract infections. MATERIALS AND METHODS. Observational, descriptive, retrospective study. Population and sample of 73 Medical Records of patients treated in the Emergency Area Adult Unit of the Carlos Andrade Marín Specialty Hospital in the period january to december 2018. Patients older than 18 years of age, of both sexes, with clinical diagnosis and due to upper and lower urinary tract infection laboratory. The information was obtained through the AS400 database, and was processed in Epi-info and Excel. RESULTS. 71,23% (52; 73) of women had urinary tract infection. Escherichia coli was frequent in 48,39% (15; 31), with greater resistance to Clotrimoxazole. Empirical treatment with Ciprofloxacin was used in 27,40% (20; 73). DISCUSSION: Controversy was observed in the types of imaging studies requested for diagnosis according to the class of urinary tract infection as well as the empirical treatment due to factors specific to each locality that prevented resistance. CONCLUSION. Escherichia coli was frequently isolated and showed greater resistance to Clotrimoxazole; the main antibiotic prescribed as empirical treatment was Ciprofloxacin; the most requested examination was the Urotomography.
Munita JM, Arias CA. HHS Public Access Mechanisms of Antibiotic Resistance. HHS Public Access. [Internet]. 2016 4(2), 1–37. DOI: https://doi.org/10.1128/microbiolspec.VMBF-0016-2015.Mechanisms. Disponible en: https://www.asmscience.org/content/journal/microbiolspec/10.1128/microbiolspec.VMBF-0016-2015
Bischoff S, Walter T, Gerigk M, Ebert M, Vogelmann R. Empiric antibiotic therapy in urinary tract infection in patients with risk factors for antibiotic resistance in a German emergency department. BMC Infect Dis. 2018; 18(1):56. Published 2018 Jan 26. DOI: 10.1186/s12879-018-2960-9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5787273/
Linsenmeyer K, Strymish J, Gupta K. Two simple rules for improving the accuracy of empiric treatment of multidrug-resistant urinary tract infections. Antimicrobial Agents and Chemotherapy. [Internet]. 2015. 59(12), 7593–7596. DOI: https://doi.org/10.1128/AAC.01638-15. Available from: https://aac.asm.org/content/59/12/7593
Gandra S, Tseng KK, Arora A, Bhowmik B, Robinson ML, Panigrahi B et al. The Mortality Burden of Multidrug-resistant Pathogens in India: A Retrospective, Observational Study. Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America. [Internet]. 2019. 69(4), 563–570. DOI: https://doi.org/10.1093/cid/ciy955. Available from: https://academic.oup.com/cid/article/69/4/563/5164350
Klein, R.D., Hultgren, S.J. Urinary tract infections: microbial pathogenesis, host–pathogen interactions and new treatment strategies. Nat Rev Microbiol 18, 211–226 (2020). DOI: https://doi.org/10.1038/s41579-020-0324-0. Available from: https://www.nature.com/articles/s41579-020-0324-0?proof=trueMay.
Long B, Koyfman A. The Emergency Department Diagnosis and Management of Urinary Tract Infection. Emergency Medicine Clinics North American, Volume 36, Issue 4, 685 – 710. DOI: 10.1016/j.emc.2018.06.003. Epub. [Internet]. 2018 Sep 6. Available from: https://pubmed.ncbi.nlm.nih.gov/30296999/
Fonseca AX. Grados de depresión en transición perimenopáusica y en menopausia en el Hospital Quito N-1 de la Policía Nacional en Julio y Agosto de 2017. Quito. Pontificia Universidad Católica del Ecuador. [Internet]. 2017. 72p. URI: http://repositorio.puce.edu.ec/handle/22000/14074. Disponible en: http://repositorio.puce.edu.ec/handle/22000/14074
Abelson B, Sun D, Que L, Nebel RA, Baker D, Popiel P, et al. Sex differences in lower urinary tract biology and physiology. Biology of Sex Differences. [Internet]. 2018. (1), 1–13. DOI: https://doi.org/10.1186/s13293-018-0204-8. Available from: https://bsd.biomedcentral.com/articles/10.1186/s13293-018-0204-8
Toker I, Kilic TY, Kose S, Yesilaras M, Unek O, Hacar S, et al. Urinary Tract Infections in the Emergency Department: Which Antibiotics are Most Appropriate? Eurasian Journal of Emergency Medicine. [Internet]. 2016. 15(3), 126–130. DOI: https://doi.org/10.5152/eajem.2016.24855. Available from: https://www.researchgate.net/publication/306920290_Urinary_Tract_Infections_in_the_Emergency_Department_Which_Antibiotics_are_Most_Appropriate
Carlsen S, Krall SP, Xu KT, Tomanec A, Farias D, Richman P. Sensitivity of urinary pathogens for patients discharged from the emergency department compared with the hospital antibiogram. BMC Emergency Medicine. [Internet]. 2019. 19(1), 50. DOI: https://doi.org/10.1186/s12873-019-0264-z. Available from: https://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-019-0264-z
Valdevenito, J. P., & Álvarez, D. (2018). Infección urinaria recurrente en la mujer. Revista Médica Clínica Las Condes, 29(2), 222–231. https://doi.org/https://doi.org/10.1016/j.rmclc.2018.02.010. Disponible en: https://www.sciencedirect.com/science/article/pii/S0716864018300282
Bader MS, Loeb M, Brooks AA. An update on the management of urinary tract infections in the era of antimicrobial resistance. Postgraduate Medicine. [Internet]. 2017. 129(2), 242–258. DOI: https://doi.org/10.1080/00325481.2017.1246055 . Available from: https://www.tandfonline.com/doi/full/10.1080/00325481.2017.1246055.
Storme O, Tirán Saucedo J, Garcia-Mora A, Dehesa-Dávila M, Naber KG. Risk factors and predisposing conditions for urinary tract infection. Ther Adv Urol. [Internet]. 2019. May 2; 11:1756287218814382. DOI: 10.1177/1756287218814382. PMID: 31105772; Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6502981/
Kornfält Isberg H, Melander E, Hedin K, Mölstad S, Beckman A. Uncomplicated urinary tract infections in Swedish primary care; Etiology, resistance and treatment. BMC Infectious Diseases. [Internet]. 2019. 19(1), 1–8. DOI: https://doi.org/10.1186/s12879-019-3785-x Available from: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-3785-x
Gupta K, Grigoryan L, Trautner B. In the clinic® urinary tract infection. Annals of Internal Medicine. [Internet]. Oct. 3 2017. 167(7), ITC49–ITC64. DOI: https://doi.org/10.7326/AITC201710030. Available from: https://www.acpjournals.org/doi/10.7326/AITC20171003
Haddad JM, Ubertazzi E, Cabrera OS, Medina M, Garcia J, Rodriguez-Colorado S, et al. Latin American consensus on uncomplicated recurrent urinary tract infection—2018. International Urogynecology Journal, [Internet]. 2020. 31(1), 35–44. DOI: https://doi.org/10.1007/s00192-019-04079-5. Available from: https://link.springer.com/article/10.1007/s00192-019-04079-5.
Kang CI, Kim J, Park DW, et al. Clinical Practice Guidelines for the Antibiotic Treatment of Community-Acquired Urinary Tract Infections. Infect Chemother. 2018; 50(1):67-100. DOI:10.3947/ic.2018.50.1.67. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5895837/
Shah Ansal, Justo JA, Bookstaver B, Kohn J, Albrecht H, Al-Hasan MN. Application of Fluoroquinolone Resistance Score in Management of Complicated Urinary Tract Infections. Antimicrobial agents and chemotherapy 61,5 e02313-16. 24 Apr. 2017. DOI:10.1128/AAC.02313-16. Available from: https://aac.asm.org/content/61/5/e02313-16
Guaman W. et al. Resistencia bacteriana de Escherichia coli uropatogénica en población nativa amerindia Kichwa de Ecuador. Rev Fac Cien Med (Quito). [Internet]. 2017; 42 (1): 36-45. Disponible en: http://revistadigital.uce.edu.ec/index.php/CIENCIAS_MEDICAS/article/view/1517/1464
Bonat G, Pickard R, Bartoletti R, Cai T, Bruyere F, Geerlings SE, Koves B, Wagenlehner F. EAU Guidelines on urological infections. 2018:1–66. European Association of Urology Guidelines on Urological Infection. Available from: https://uroweb.org/wp-content/uploads/EAU-Guidelines-on-Urological-Infections-2018-large-text.pdf.
Chee WT, Chlebicki MP. Urinary tract infections in adults. Singapore Medical Journal. [Internet]. 2016. 57(9), 485–490. DOI: https://doi.org/10.11622/smedj.2016153. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027397/
Government of Western Australia. (2018). Diagnostic Imaging Pathways - Loin Pain (Acute Pyelonephritis). 1–7. Available from: http://www.imagingpathways.health.wa.gov.au/index.php/imaging-pathways/gastrointestinal/acute-abdomen/acute-flank-loin-pain-acute-pyelonephritis#pathway.
Nicolle L, Gupta K, Bradley S, Colgan R, DeMuri G, Drekonja D et al. Clinical Practice Guideline for the Management of Asymptomatic Bacteriuria: 2019 Update by the Infectious Diseases Society of America. DOI: https://doi.org/10.1093/cid/ciy1121. Clinical Infectious Diseases. 2019; Available from: https://www.idsociety.org/practice-guideline/asymptomatic-bacteriuria/
Lee D, Lee S, Choe H. Community-Acquired Urinary Tract Infection by Escherichia coli in the Era of Antibiotic Resistance. BioMed Research International. 2018; 1-14. DOI: 10.1155/2018/7656752. Available from: https://pubmed.ncbi.nlm.nih.gov/30356438/
Smith SC, Bazzoli C, Chung I, Johnson A, Martin DR. Antimicrobial Susceptibility of Escherichia coli in Uncomplicated Cystitis in the Emergency Department: Is the Hospital Antibiogram an Effective Treatment Guide?. Academic Emergency Medicine. [Internet]. 2015. 22(8), 998–1000. DOI: https://doi.org/10.1111/acem.12729. Available from: https://pubmed.ncbi.nlm.nih.gov/26250654/
Zatorski C, Jordan JA, Cosgrove SE, Zocchi M, May L. Comparison of antibiotic susceptibility of Escherichia coli in urinary isolates from an emergency department with other institutional susceptibility data. American Journal of Health-System Pharmacy. [Internet]. 2015. 72(24), 2176–2180. DOI: https://doi.org/10.2146/ajhp140832. Available from: https://academic.oup.com/ajhp/article-abstract/72/24/2176/5111598?redirectedFrom=fulltext
Hitzenbichler F, Simon M, Holzmann T, Iberer M, Zimmermann M, Salzberger B, et al. Antibiotic resistance in E. coli isolates from patients with urinary tract infections presenting to the emergency department. Infection. 2018 46(3), 325–331. DOI: https://doi.org/10.1007/s15010-018-1117-5. [Internet]. Available from: https://link.springer.com/article/10.1007%2Fs15010-018-1117-5
Pormohammad A, Nasiri MJ, Azimi T. Prevalence of antibiotic resistance in escherichia coli strains simultaneously isolated from humans, animals, food, and the environment: A systematic review and meta-analysis. Infection and Drug Resistance. [Internet]. 2019. 12, 1181–1197. DOI: https://doi.org/10.2147/IDR.S201324. Available from: https://www.dovepress.com/prevalence-of-antibiotic-resistance-in-escherichia-coli-strains-simult-peer-reviewed-article-IDR
Losada I, Barbeito G, García-Garrote F, Fernández-Pérez B, Malvar A, Hervada X et al. Estudio de sensibilidad de Escherichia coli productores de infecciones del tracto urinario comunitarias en Galicia. Período: 2016-2017. Atención Primaria. 2020; 52(7):462-468. Available from: https://www.sciencedirect.com/science/article/pii/S0212656718304748
Gardiner B, Stewardson A, Abbott I, Peleg A. Nitrofurantoin and fosfomycin for resistant urinary tract infections: old drugs for emerging problems. Australian Prescriber. 2019;42(1):14 Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370609/
Huttner A et al. Verhaegh E, Harbarth S, Muller A, Theuretzbacher U, Mouton J. Nitrofurantoin revisited: a systematic review and meta-analysis of controlled trials. Journal of Antimicrobial Chemotherapy. 2015; 70(9):2456-64. DOI: 10.1093/jac/dkv147. Available from: https://pubmed.ncbi.nlm.nih.gov/26066581/
The authors who publish in this journal accept the following conditions:
1. The authors retain the copyright and grant to the CAMbios MEDICAL-SCIENTIFIC JOURNAL HECAM the right of the first publication, with the work registered with the Creative Commons attribution license, which allows third parties to use the published material provided that they mention the authorship of the work and the first publication in this journal.
2. Authors can make other independent and additional contractual agreements for the non-exclusive distribution of the version of the article published in this journal (for example, include it in an institutional repository or publish it in a book) as long as it clearly indicates that the work was published. for the first time in the CAMbios MEDICAL-SCIENTIFIC JOURNAL HECAM.
