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Antibiotics 2014, 3(1), 98-108; doi:10.3390/antibiotics3010098
Article

Uncomplicated Urinary Tract Infections in Women in a Sao Paulo Quaternary Care Hospital: Bacterial Spectrum and Susceptibility Patterns

1
, 1,* , 2
 and 1
1 Division of Urology, Hospital das Clinicas-SP, University of Sao Paulo, 255 Doutor Enéas Carvalho de Aguiar Ave., 7th floor, São Paulo 05403-000, Brazil 2 Infectious Disease Department, Hospital das Clinicas-SP, University of Sao Paulo, 255 Doutor Enéas Carvalho de Aguiar Ave., 4th floor, São Paulo 05403-000, Brazil
* Author to whom correspondence should be addressed.
Received: 6 January 2014 / Revised: 14 February 2014 / Accepted: 21 February 2014 / Published: 19 March 2014
(This article belongs to the Special Issue Antibiotics and Urinary Tract Infections)
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Abstract

Uncomplicated urinary tract infections (UTI) in women are very common. Regular analysis of bacterial flora is important to formulate updated guidelines. The objective of this study is to determine and compare the microbiology of UTIs and their susceptibility patterns in a quaternary care hospital. In a seven-year review, the urine culture results of 480 female patients with uncomplicated UTIs were analyzed. Patients were divided into three groups according to their diagnosis and treatment characteristics: Group 1, cystitis at outpatient basis; group 2, cystitis at the Emergency Unit; and group 3, pyelonephritis. Group 1 included older patients, with a higher incidence of concomitant diabetes mellitus and recurrent UTIs. E. coli was the most common pathogen, responsible for 75.1% of cases, mainly for pyelonephritis (87.3%). Of the oral antimicrobials tested for cystitis, amoxicillin/clavulanate and nitrofurantoin had the highest susceptibility profiles (84.4% and 87.3%, respectively). For E. coli only, their susceptibility profiles were as high as 90.8% and 97.4%, respectively. For pyelonephritis treatment, fluoroquinoles had a susceptibility profile <90%, while ceftriaxone and gentamicin had susceptibility >90%. Uncomplicated UTI treatment is becoming more challenging because the susceptibility profiles of oral antimicrobials are increasingly resistant. In our environment, cystitis can still be managed with nitrofurantoin. Uncomplicated pyelonephritis should be managed with ceftriaxone or gentamicin.
Keywords: urinary tract infection; female; cystitis; pyelonephritis urinary tract infection; female; cystitis; pyelonephritis
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Hisano, M.; Bruschini, H.; Nicodemo, A.C.; Srougi, M. Uncomplicated Urinary Tract Infections in Women in a Sao Paulo Quaternary Care Hospital: Bacterial Spectrum and Susceptibility Patterns. Antibiotics 2014, 3, 98-108.

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