title: Frequency and antibiotic susceptibility patterns of urinary pathogens in male outpatients in Argentina.
abstract: BACKGROUND
  Knowledge of the etiology and antimicrobial susceptibility patterns of uropathogens is important for determining the best treatment option. This study aimed to determine the distribution and antibiotic susceptibility patterns of bacterial strains isolated from adult male outpatients.
  
  
  METHODS
  Between November 2012 and April 2013, 3,105 community urine samples were analyzed from adult male patients who attended the Laboratorio Hidalgo, Buenos Aires, Argentina. Antimicrobial susceptibility testing was performed by the Kirby-Bauer disc diffusion method. Isolates resistant to third generation cephalosporin were tested for extended-spectrum beta-lactamase (ESBL) production using the double-disk synergy test.
  
  
  RESULTS
  Of the 3,105 urine samples analyzed, 791 (25.5%) had significant bacteriuria. The frequency of positive urine cultures increased significantly with patient age. Escherichia coli was isolated most frequently (47.3%), followed by Enterococcus faecalis (13.6%), and Klebsiella pneumoniae (11.9%). Gram-negative organisms represented 78.8% of urinary pathogens. The highest activities against Gram-negative bacteria were found with imipenem (99.0%), amikacin (98.1%), ertapenem (94.2%), fosfomycin (90.7%), and piperacillin-tazobactam (90.1%). The frequencies of ESBLs among E. coli, K. pneumoniae, and P. mirabilis were 15.2 %, 22.3%, and 8%, respectively. Fosfomycin, piperacillin-tazobactam, and nitrofurantoin were most effective against Gram-positive organisms.
  
  
  CONCLUSIONS
  Fosfomycin may be an excellent option for cystitis treatment in patients without risk factors, whereas piperacillin-tazobactam is preferred for the treatment of parenchymatous UTIs, complicated UTIs, and UTIs associated with risk factors. To ensure the optimal selection of antibiotics, physicians should have access to up-to-date information about the local prevalence of antimicrobial resistance.
authors.affiliation: Laboratorio Hidalgo, Buenos Aires, Argentina. villarh2003@yahoo.com.ar.
authors.forename: Hugo E
authors.initials: HE
authors.lastname: Villar
authors.forename: Mónica B
authors.initials: MB
authors.lastname: Jugo
authors.forename: Alejandro
authors.initials: A
authors.lastname: Macan
authors.forename: Matias
authors.initials: M
authors.lastname: Visser
authors.forename: Mariana
authors.initials: M
authors.lastname: Hidalgo
authors.forename: Gustavo Cesar
authors.initials: GC
authors.lastname: Maccallini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001118:Argentina; D001437:Bacteriuria / Q000188:drug therapy / Q000382:microbiology; D003906:Developing Countries; D024881:Drug Resistance, Bacterial; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010045:Outpatients; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology*