title: Antimicrobial resistance of uropathogens in women with acute uncomplicated cystitis from primary care settings.
abstract: We assessed the antimicrobial resistance patterns of all urine samples submitted for culture from outpatient women aged ≥14 years with diagnosis of uncomplicated cystitis over a 24-month period (2007-2009) in the city of Fortaleza, Brazil. Only bacterial growth of a single uropathogen with ≥10(5) CFU/mL was considered for analysis. The Pearson's chi-square test was used for bivariate correlations. Escherichia coli presented the highest prevalence (64.7%). Coagulase-negative staphylococcus was more common in younger than in older women (P = 0.003). Gentamicin presented the lowest overall resistance pattern (3.5% resistant), followed by ceftriaxone (5%) and norfloxacin (7.5%). Ampicillin and trimethoprim-sulfamethoxazole were the least active agents with 63.7% and 39.8% of resistance, respectively. The resistant rate to trimethoprim-sulfamethoxazole was significantly higher among E. coli than non-E. coli isolated. Among ciprofloxacin-resistant E. coli strains, only 3.4% were resistant to nitrofurantoin. We conclude that trimethoprim-sulfamethoxazole follows a worldwide tendency of antimicrobial increasing resistance and it should be avoided as first-line empirical treatment for urinary tract infections.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, School of Medicine, Walter Cantídio University Hospital, Federal University of Ceará, UFC, Rua Prof. Costa Mendes, 1608, Fortaleza, CE, CEP 60430-040, Brazil.
authors.forename: Sônia M H A
authors.initials: SM
authors.lastname: Araújo
authors.forename: Thiago C
authors.initials: TC
authors.lastname: Mourão
authors.forename: Jobson L
authors.initials: JL
authors.lastname: Oliveira
authors.forename: Igor F S
authors.initials: IF
authors.lastname: Melo
authors.forename: Constance A A
authors.initials: CA
authors.lastname: Araújo
authors.forename: Nicole A A
authors.initials: NA
authors.lastname: Araújo
authors.forename: Matias C A
authors.initials: MC
authors.lastname: Melo
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Araújo
authors.forename: Elizabeth F
authors.initials: EF
authors.lastname: Daher
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D003556:Cystitis / Q000188:drug therapy* / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011320:Primary Health Care; D012189:Retrospective Studies; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology*; D055815:Young Adult