title: Antibiotic Resistance of Bacteria Involved in Urinary Infections in Brazil: A Cross-Sectional and Retrospective Study.
abstract: Empirical and prolonged antimicrobial treatment of urinary tract infections caused by Escherichia coli is associated with the emergence of bacterial resistance, and not all countries have strict policies against the indiscriminate use of drugs in order to prevent resistance. This cross-sectional and retrospective study (2010-2015) aimed to evaluate the sensitivity and resistance of patient-derived E. coli to different drugs broadly used to treat urinary infections in Brazil: ampicillin + sulbactam, cephalothin, ciprofloxacin, norfloxacin, and nitrofurantoin. We obtained 1654 E. coli samples from ambulatory patients with disease symptoms of the urinary tract from a Brazilian public hospital. While all antibiotics were effective in killing E. coli to a large degree, nitrofurantoin was the most effective, with fewer samples exhibiting antibiotic resistance. We assessed the costs of generic and brand name versions of each antibiotic. Nitrofurantoin, the most effective antibiotic, was the cheapest, followed by the fluoroquinolones (ciprofloxacin and norfloxacin), ampicillin + sulbactam and, lastly, cephalothin. Finally, assessment of antibiotic resistance to fluoroquinolones over the study period and extrapolation of the data led to the conclusion that these antibiotics could no longer be effective against E. coli-based urinary infections in approximately 20 years if their indiscriminate use in empirical treatment continues.
authors.affiliation: Postgraduate Course in Health Sciences, Federal University of Triângulo Mineiro, 38061-500 Uberaba, MG, Brazil. wellington.frodrigues@hotmail.com.|Institute of Genetics and Biochemistry, Federal University of Uberlandia, 38400-902 Uberlandia, MG, Brazil. wellington.frodrigues@hotmail.com.|Faculty Morgana Potrich-FAMP, 75830-000 Mineiros, GO, Brazil. wellington.frodrigues@hotmail.com.
authors.forename: Wellington Francisco
authors.initials: WF
authors.lastname: Rodrigues
authors.affiliation: Postgraduate Course in Health Sciences, Federal University of Triângulo Mineiro, 38061-500 Uberaba, MG, Brazil. camilabmiguel@hotmail.com.
authors.forename: Camila Botelho
authors.initials: CB
authors.lastname: Miguel
authors.affiliation: Institute of Genetics and Biochemistry, Federal University of Uberlandia, 38400-902 Uberlandia, MG, Brazil. anap812004@yahoo.com.br.
authors.forename: Ana Paula Oliveira
authors.initials: AP
authors.lastname: Nogueira
authors.affiliation: Institute of Genetics and Biochemistry, Federal University of Uberlandia, 38400-902 Uberlandia, MG, Brazil. ueira@ingeb.ufu.br.
authors.forename: Carlos
authors.initials: C
authors.lastname: Ueira-Vieira
authors.affiliation: Laboratório de Pesquisas do Cefores, Universidade Federal do Triângulo Mineiro, 38015-050 Uberaba, MG, Brazil. tppfarmacia@icloud.com.
authors.forename: Tony De Paiva
authors.initials: Tde P
authors.lastname: Paulino
authors.affiliation: Institute of Biological and Natural Sciences, Federal University of Triângulo Mineiro, 38015-050 Uberaba, MG, Brazil. siomars@gmail.com.
authors.forename: Siomar De Castro
authors.initials: Sde C
authors.lastname: Soares
authors.affiliation: Clinical Hospital, Division of Endocrinology, Federal University of Triângulo Mineiro, 38025-180 Uberaba, MG, Brazil. elisabete@mednet.com.br.
authors.forename: Elisabete Aparecida Mantovani Rodrigues
authors.initials: EA
authors.lastname: De Resende
authors.affiliation: Postgraduate Course in Health Sciences, Federal University of Triângulo Mineiro, 38061-500 Uberaba, MG, Brazil. jlazo@dcb.uftm.edu.br.|Institute of Biological and Natural Sciences, Federal University of Triângulo Mineiro, 38015-050 Uberaba, MG, Brazil. jlazo@dcb.uftm.edu.br.
authors.forename: Javier Emilio
authors.initials: JE
authors.lastname: Lazo-Chica
authors.affiliation: Clinical Pathology Service, Microbiology, Federal University of Triângulo Mineiro, 38025-180 Uberaba, MG, Brazil. marcelo.costa2006@hotmail.com.
authors.forename: Marcelo Costa
authors.initials: MC
authors.lastname: Araújo
authors.affiliation: Institute of Biological and Natural Sciences, Federal University of Triângulo Mineiro, 38015-050 Uberaba, MG, Brazil. carlo@icbn.uftm.edu.br.
authors.forename: Carlo José
authors.initials: CJ
authors.lastname: Oliveira
mesh_terms: D000667:Ampicillin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001938:Brazil / Q000453:epidemiology; D002939:Ciprofloxacin / Q000494:pharmacology; D003430:Cross-Sectional Studies; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D004926:Escherichia coli / Q000187:drug effects*; D004927:Escherichia coli Infections / Q000382:microbiology*; D024841:Fluoroquinolones / Q000494:pharmacology; D006801:Humans; D008826:Microbial Sensitivity Tests; D009582:Nitrofurantoin / Q000494:pharmacology; D012189:Retrospective Studies; D013407:Sulbactam / Q000494:pharmacology; D014552:Urinary Tract Infections / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D002939:Ciprofloxacin; C035444:sultamicillin; D000667:Ampicillin; D009582:Nitrofurantoin; D013407:Sulbactam
keywords: Escherichia coli; antibiotics; bacterial resistance; urinary infection