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Antimicrobial resistance of uropathogens in women with acute uncomplicated cystitis from primary care settings

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Abstract

We assessed the antimicrobial resistance patterns of all urine samples submitted for culture from outpatient women aged ≥14 years with diagnosis of uncomplicated cystitis over a 24-month period (2007–2009) in the city of Fortaleza, Brazil. Only bacterial growth of a single uropathogen with ≥105 CFU/mL was considered for analysis. The Pearson’s chi-square test was used for bivariate correlations. Escherichia coli presented the highest prevalence (64.7%). Coagulase-negative staphylococcus was more common in younger than in older women (P = 0.003). Gentamicin presented the lowest overall resistance pattern (3.5% resistant), followed by ceftriaxone (5%) and norfloxacin (7.5%). Ampicillin and trimethoprim-sulfamethoxazole were the least active agents with 63.7% and 39.8% of resistance, respectively. The resistant rate to trimethoprim-sulfamethoxazole was significantly higher among E. coli than non-E. coli isolated. Among ciprofloxacin-resistant E. coli strains, only 3.4% were resistant to nitrofurantoin. We conclude that trimethoprim-sulfamethoxazole follows a worldwide tendency of antimicrobial increasing resistance and it should be avoided as first-line empirical treatment for urinary tract infections.

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Acknowledgments

Authors are thankful to the Centro de Especialidades Médicas José de Alencar for providing computer facilities. We thank Mr. Hermano Alexandre L. Rocha for assistance in the statistical analysis.

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Authors and Affiliations

  1. Division of Nephrology, Department of Internal Medicine, School of Medicine, Walter Cantídio University Hospital, Federal University of Ceará, UFC, Rua Prof. Costa Mendes, 1608, Fortaleza, CE, CEP 60430-040, Brazil

    Sônia M. H. A. Araújo & Elizabeth F. Daher

  2. School of Medicine, Walter Cantídio University Hospital, Federal University of Ceará, UFC, Rua Prof. Costa Mendes, 1608, Fortaleza, CE, CEP 60430-040, Brazil

    Thiago C. Mourão, Jobson L. Oliveira, Igor F. S. Melo, Matias C. A. Melo & Samuel R. Araújo

  3. School of Medicine, Severino Sombra University, Av. Expedicionário Oswaldo de Almeida Ramos, 280, Vassouras, RJ, CEP 27700-000, Brazil

    Constance A. A. Araújo & Nicole A. A. Araújo

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  1. Sônia M. H. A. Araújo
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  2. Thiago C. Mourão
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  3. Jobson L. Oliveira
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  4. Igor F. S. Melo
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  5. Constance A. A. Araújo
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  6. Nicole A. A. Araújo
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  7. Matias C. A. Melo
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  8. Samuel R. Araújo
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  9. Elizabeth F. Daher
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Correspondence to Elizabeth F. Daher.

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Araújo, S.M.H.A., Mourão, T.C., Oliveira, J.L. et al. Antimicrobial resistance of uropathogens in women with acute uncomplicated cystitis from primary care settings. Int Urol Nephrol 43, 461–466 (2011). https://doi.org/10.1007/s11255-010-9777-9

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  • DOI: https://doi.org/10.1007/s11255-010-9777-9

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