The Open Infectious Diseases Journal

ISSN: ― Volume ,

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.

Keywords: β-lactamases, Elderly patients, Escherichia coli, Infections, Resistance, Urinary tract.

Article Information

Identifiers and Pagination:

Year: 2018
Volume: 10
First Page: 79
Last Page: 87
Publisher Id: TOIDJ-10-79
DOI: 10.2174/1874279301810010079

Article History:

Received Date: 30/3/2018
Revision Received Date: 18/6/2018
Acceptance Date: 27/6/2018
Electronic publication date: 19/7/2018
Collection year: 2018

© 2018 Delpech et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* 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:

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