High Microbiological Spectrum Resistance Rates in Urine Isolates from Jalisco, Mexico. A Retrospective Study and Literature Review
Keywords:Antimicrobial resistance, E. coli, Extended spectrum beta lactamases, Urine culture
Background: Urinary tract infections (UTIs) are a major public healthÂ problem worldwide. In Latin America, most UTIs are treated withoutÂ bacteriological identifiation. Our aim was to examine resistance ratesÂ to commonly prescribed antibiotics, focusing on cases from Jalisco,Â Mexico; and additionally to conduct a review of the literature to searchÂ for resistance patterns in other countries of Latin America.
Methods: Retrospective analysis of urine cultures from ambulatoryÂ and hospitalized patients taken from Nov 2012-Nov 2013; susceptibility testing and minimal inhibitory concentration (MIC) was done byÂ microdilution methodology. For literature search, we reviewed diffeÂ rent data bases and included papers in English and Spanish, publishedÂ from 2007-2014, representative from the Latin America region.
Results: We obtained 1.206 consecutive samples from outpatientÂ and inpatient facilities, including adult and pediatric subjects. TheÂ most frequent isolate in all groups was ESBL-producing E. coli withÂ high resistance rates for ampicillin, TMP-SMX, and ciproflxacin. InÂ the literature review we found 15 papers related to resistance ratesÂ of commonly prescribed antibiotics.
Conclusions: The information summarized in this article supportsÂ the fiding that resistance rates to commonly prescribed antimicrobialÂ agents are increasing worldwide. As such, this study challenges theÂ rationale behind empiric use of antibiotics, emphasizing the need,Â whenever possible, to perform urine cultures before initiating antimicrobial treatment.
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