title: Incidence and diversity of antimicrobial multidrug resistance profiles of uropathogenic bacteria.
abstract: The aim of this study was to assess the most frequent multidrug resistant (MDR) profiles of the main bacteria implicated in community-acquired urinary tract infections (UTI). Only the MDR profiles observed in, at least, 5% of the MDR isolates were considered. A quarter of the bacteria were MDR and the most common MDR profile, including resistance to penicillins, quinolones, and sulfonamides (antibiotics with different mechanisms of action, all mainly recommended by the European Association of Urology for empirical therapy of uncomplicated UTI), was observed, alone or in association with resistance to other antimicrobial classes, in the main bacteria implicated in UTI. The penicillin class was included in all the frequent MDR profiles observed in the ten main bacteria and was the antibiotic with the highest prescription during the study period. The sulfonamides class, included in five of the six more frequent MDR profiles, was avoided between 2000 and 2009. The results suggest that the high MDR percentage and the high diversity of MDR profiles result from a high prescription of antibiotics but also from antibiotic-resistant genes transmitted with other resistance determinants on mobile genetic elements and that the UTI standard treatment guidelines must be adjusted for the community of Aveiro District.
authors.affiliation: Department of Biology and CESAM, University of Aveiro, 3810-193 Aveiro, Portugal.
authors.forename: Inês
authors.initials: I
authors.lastname: Linhares
authors.affiliation: Clinical Analysis Laboratory Avelab, Rua Cerâmica do Vouga, 3800-011 Aveiro, Portugal.
authors.forename: Teresa
authors.initials: T
authors.lastname: Raposo
authors.affiliation: Clinical Analysis Laboratory Avelab, Rua Cerâmica do Vouga, 3800-011 Aveiro, Portugal.
authors.forename: António
authors.initials: A
authors.lastname: Rodrigues
authors.affiliation: Department of Biology and CESAM, University of Aveiro, 3810-193 Aveiro, Portugal.
authors.forename: Adelaide
authors.identifier: 0000-0002-8422-8664
authors.initials: A
authors.lastname: Almeida
mesh_terms: D001419:Bacteria / Q000187:drug effects* / Q000235:genetics / Q000472:pathogenicity; D017714:Community-Acquired Infections / Q000235:genetics / Q000382:microbiology* / Q000652:urine; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D006801:Humans; D010406:Penicillins / Q000627:therapeutic use; D015363:Quinolones / Q000627:therapeutic use; D013449:Sulfonamides / Q000627:therapeutic use; D014552:Urinary Tract Infections / Q000235:genetics / Q000382:microbiology* / Q000652:urine; D014556:Urine / Q000382:microbiology
chemical_list: D010406:Penicillins; D015363:Quinolones; D013449:Sulfonamides
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