Antimicrobial Resistance of Uropathogenic Escherichia coli from Elderly Patients at a General Hospital, Argentina
Gastón Delpech1, Natalia García Allende2, Sabina Lissarrague3, Mónica Sparo3, *
1 CIVETAN (CONICET-UNCPBA), Tandil, Argentina
2 Servicio de Infectología, Epidemiología Hospitalaria e Inmunologia, Hospital Alemán, Buenos Aires, Argentina
3 Laboratorio de Microbiología Clínica, Hospital Ramón Santamarina, Tandil, Argentina
Urinary Tract Infection (UTI) is a common cause of morbidity and mortality in older adults.
To investigate antimicrobial resistance of uropathogenic Escherichia coli from elderly patients in a General Hospital, Argentina.
During the period July 2011-July 2015, patients over 70 years old with urinary tract infections, without urinary catheters and with no antimicrobial therapy the previous week before sampling, were included. Phenotypic characterization was carried out. In vitro qualitative and quantitative antimicrobial resistances were investigated. Antimicrobials assayed: ampicillin, amoxicillin-clavulanate, cefazolin, cefuroxime, cefoxitin, cefotaxime, ceftazidime, cefepime, imipenem, ertapenem, gentamicin, nalidixic acid, ciprofloxacin, trimethoprim-sulfamethoxazole (TMS) and nitrofurantoin. Patients’ medical records were produced, and risk factors were analyzed by multivariate analysis.
768 bacterial isolates were identified as E. coli. Resistances to ampicillin (80.5%), nalidixic acid (61.7%), ciprofloxacin (42.8%), TMS (37.6%), amoxicillin-clavulanate (28.6%), cefazolin (21.6%), cefuroxime (20.7%), gentamicin (13.8%), cefotaxime (9.7%), ceftazidime (9.7%), cefepime (8.4%), cefoxitin (3.1%) and nitrofurantoin (2.3%) were observed. Resistance to carbapenems was not expressed. Production of extended spectrum β-lactamases was detected (7.6%) in community acquired (96%) and healthcare associated (4%) isolates. The independent risk factors for urinary infections produced by multi-resistant E. coli were: diabetes mellitus, recurrent infections, hospitalization during the last year and exposure to β-lactams in the last 3 months.
A high prevalence of resistance to β-lactams and to other antimicrobials was observed. Detection of antimicrobial multi-resistant isolates highlights the need of antimicrobial resistance surveillance in elderly patients with urinary tract infections.
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* Address correspondence to this author at the Laboratorio de Microbiología Clínica, Hospital Ramón Santamarina, Gral. Paz 1406. CP 7.000, Tandil, Buenos Aires, Argentina; Tel: +54-249-442-2011; E-mail: firstname.lastname@example.org