Sensibilidad microbiana de escherichia coli en bacteriurias en el área sanitaria del Bierzo en el año 2003 / Antimicrobial susceptibility of escherichia coli isolated from bacteriurias in Bierzo Health Area during 2003

OBJETIVO: Evaluar la sensibilidad a varios antibióticos en cepas de Escherichia coli aisladas en muestras de orina de pacientes hospitalarios y extrahospitalarios. MATERIAL Y MÉTODOS: Se analizaron los urocultivos positivos para Escherichia coli obtenidos de muestras de pacientes hospitalizados y atendidos en consultas externas hospitalarias y atención primaria. Se determinó la sensibilidad de este germen a diecinueve antibióticos de uso hospitalario y/o extrahospitalario. RESULTADOS: Según el origen hospitalario, consultas externas hospitalarias y atención primaria, respectivamente, la sensibilidad in vitro ha sido la siguiente: imipenem (100%, 100% y 100%; p=NS), amikacina (100%, 100% y 99,7%; p=NS), fosfomicina (98,6%, 98,4% y 99,6%; p=NS), cefepima (96%, 96,9% y 98,3%; p=NS), piperacilina-tazobactam (96%, 95,3% y 96,6%; p=NS), aztreonam (93,5%, 94,7% y 97,7%; p<0,001), ceftazidima (93,5%, 94,3% y 97,8%; p<0,001), cefotaxima (93,1%, 95% y 97,7%; p<0,001), cefixima (92,7%, 94,6% y 96,7%; p<0,05), nitrofurantoína (92%, 94,7% y 94,7%; p=NS), cefuroxima (88,4%, 93,1% y 95%; p<0,001), amoxicilina-clavulánico (87,7%, 88,7% y 93,8%; p<0,001), tobramicina (87%, 93,7% y 93,8%; p<0,001), gentamicina (85,9%, 92,8% y 93%; p<0,001), cefazolina (84,4%, 88,7% y 91,6%; p<0,01), ciprofloxacino (63,8%, 71,4%, 78,4%; p<0,001), norfloxacino (63%, 70,8 y 78,2%; p<0,001), cotrimoxazol (65,2%, 68,6% y 74,9%; p<0,01) y ampicilina (35,5%, 42,5% y 47,8%; p<0,01). (NS= No significativo). CONCLUSIONES: El tratamiento de las infecciones del tracto urinario frecuentemente se inicia de forma empírica. Por este motivo resulta esencial conocer los patrones de sensibilidad de las bacterias potencialmente causantes del cuadro

OBJECTIVE: Sensitivity to antibiotics of Escherichia coli isolated from intrahospital and extrahospital bacteriurias is analized. MATERIAL AND METHODS: Sensitivity to nineteen antibiotics used in the clinical practise was determined in strains of Escherichia coli isolated from intrahospital and extrahospital bacteriurias. RESULTS: The prevalence of in-vitro susceptibilities to antibiotics were (hospital, state health service clinic, health center-primary-care): imipenem (100%-100%-100%; p=NS), amikacin (100%-100%-99.7%; p=NS), fosfomicyn (98.6%- 98.4%-99.6%; p=NS), cefepime (96%-96.9%-98.3%; p=NS), piperacillin-tazobactam (96%-95.3%-96.6%; p=NS), aztreonam (93.5%-94.7%-97.7%; p<0.001), ceftazidime (93.5%-94.3%-97.8%; p<0.001), cefotaxime (93.1%-95%-97.7%; p<0.001), cefixime (92.7%-94.6%-96.7%; p<0.05), nitrofurantoin (92%-94.7%-94.7%; p=NS), cefuroxime (88.4%-93.1%- 95%; p<0.001), amoxicillin-clavulanic (87.7%-88.7%-93.8%; p<0.001), tobramicyn (87%-93.7%-93.8%; p<0.001), gentamcin (85.9%-92.8%-93%; p<0.001), cefazolin (84.4%-88.7%-91.6%; p<0.01), ciprofloxacin (63.8%-71.4%-78.4%; p<0.001), norfloxacin (63%-70.8%-78.2%; p<0.001), cotrimoxazole (65.2%-68.6%-74.9%; p<0.01) and ampicillin (35.5%-42.5%-47.8%; p<0.01). (*NS= No significant differences). CONCLUSIONS: The knowledge of the sensitivity of uropathogens to antimicrobians can allow us to initiate empirical therapy of urinary tract infections

[Microbial sensitivity of Escherichia coli in community-acquired urinary tract infections]. / Sensibilidad microbiana de Escherichia coli en infecciones urinarias extrahospitalarias.

OBJECTIVE: For effective empiric therapy of urinary tract infections in the extra-hospital setting the susceptibility pattern of uropathogens should be considered. Moreover, the evolution in sensitivity can be observed when comparing with susceptibility patterns in the previous years. This paper presents an analysis of our experience with Escherichia coli. MATERIAL AND METHODS: During 2002 and 1998, 895 and 595 strains of Escherichia coli respectively, isolated from extrahospitalary bacteriurias were collected in ten health centers in Bierzo (León, Spain). Sensitivity to nine most commonly antibiotics used in the clinical practise was determined. The existence of significant differences of susceptibility among years (2002-1998) was analyzed by the chi square test. RESULTS: Escherichia coli accounted for 63.4% of all isolates in 2002 and 50.8% in 1998. The prevalence of in-vitro susceptibilities to antibiotics were (2002-1998): fosfomycin (99.2%-99.3%; p = NS*), cefixime (98.3%-92.9%; p < 0.001), cefuroxime (96.5%-94.1%; p < 0.05), nitrofurantoin (94.5%-86.9%; p < 0.001), amoxycillin-clavulanic acid (93.1%-90.1%; p < 0.05), ciprofloxacin (77.1%-81.6%; p < 0.05), norfloxacin (75.8%-80.3%; p < 0.05), cotrimoxazole (71.5%-73.4%; p = NS*) and ampicillin (44%-41.4%; p = NS*). (*NS = No significant differences). CONCLUSION: The knowledge of the sensitivity of uropathogens to antimicrobians in a specific medium can allow us to use antibiotics rationally and initiate empirical therapy.