title: The Bacterial Spectrum and Antimicrobial Susceptibility in Female Recurrent Urinary Tract Infection: How Different They Are From Sporadic Single Episodes?
abstract: OBJECTIVE
  To analyze and compare the etiological uropathogens and the susceptibility profile findings on urine culture between sporadic cases of community-acquired, uncomplicated urinary tract infection (UTI) and recurrent UTI cases in women.
  
  
  METHODS
  We retrospectively analyzed the clinical data of 1629 women with uncomplicated UTI evaluated at our hospital between January 2007 and December 2012. Patients were divided into 2 groups: (1) no recurrent UTI and (2) recurrent UTI. We analyzed the microbiological findings and compared susceptibility profiles between groups.
  
  
  RESULTS
  A total of 420 women were included. Group 1 had 233 (55.5%) patients and group 2 had 187 (44.5%). Escherichia coli was the most common agent in both groups (76.4% and 74.3%, respectively; P = .625), whereas Staphylococcus saprophyticus (8.2%) was the second most common in group 1, and Enterococcus faecalis was the second most common in group 2 (8.0%). Nitrofurantoin was the only oral agent that maintained the susceptibility profile in both groups (87.1% and 88.7%, respectively; P = .883). For E coli infections, only nitrofurantoin and amoxicillin/clavulanate maintained susceptibility rates more than 90% in both groups.
  
  
  CONCLUSIONS
  UTI episodes in patients with recurrent UTI had similar bacterial spectra, but different susceptibility profiles compared with those from patients with nonrecurrent infections. The susceptibility rate for nitrofurantoin in patients with recurrent UTI remained high and comparable to the observed in patients with sporadic UTI, reinforcing its indication for empirical treatment while waiting for urine culture results.
authors.affiliation: Division of Urology, Hospital das Clínicas, University of São Paulo, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Hisano
authors.affiliation: Division of Urology, Hospital das Clínicas, University of São Paulo, Brazil. Electronic address: bruschini@uol.com.br.
authors.forename: Homero
authors.initials: H
authors.lastname: Bruschini
authors.affiliation: Department of Infectious Disease, Hospital das Clínicas, University of São Paulo, Brazil.
authors.forename: Antonio Carlos
authors.initials: AC
authors.lastname: Nicodemo
authors.affiliation: Division of Urology, Hospital das Clínicas, University of São Paulo, Brazil.
authors.forename: Cristiano Mendes
authors.initials: CM
authors.lastname: Gomes
authors.affiliation: Division of Urology, Hospital das Clínicas, University of São Paulo, Brazil.
authors.forename: Marcos
authors.initials: M
authors.lastname: Lucon
authors.affiliation: Division of Urology, Hospital das Clínicas, University of São Paulo, Brazil.
authors.forename: Miguel
authors.initials: M
authors.lastname: Srougi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000892:Anti-Infective Agents, Urinary / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial; D013293:Enterococcus faecalis / Q000302:isolation & purification; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D006801:Humans; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009582:Nitrofurantoin / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D057790:Staphylococcus saprophyticus / Q000302:isolation & purification; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000892:Anti-Infective Agents, Urinary; D009582:Nitrofurantoin