a Community-acquired urinary tract infections in Divinópolis, Brazil: assesment of bacterial resistance profile and clinical management Objetivo: Analisar o perfil de resistência bacteriana e o manejo clínico das infecções do trato urinário (ITU) no município de Divinópolis, MG. Métodos: Trata-se de estudo transversal descritivo, cujos dados foram obtidos a partir das uroculturas positivas realizadas no primeiro semestre de 2015 no Laboratório Municipal de Microbiologia e por meio de entrevistas com médicos atuantes na atenção básica de Divinópolis, MG. Resultados: Das uroculturas avaliadas (N=802), 72,8% isolaram a bactéria Escherichia coli, sendo 38,6% delas resistentes ao sulfametoxazol+trimetoprima, 33,0% ao norfloxacino, 31,8% ao ciprofloxacino e 9,0% à nitrofurantoína. Dos 57 médicos entrevistados, 73,5% solicitam, habitualmente, algum exame laboratorial para cistite aguda não complicada. Os antimicrobianos de primeira escolha no tratamento empírico das ITU, segundo os entrevistados, foram norfloxacino (56,1%), sulfametoxazol+trimetoprima (19,3%), ciprofloxacino (10,5%) e nitrofurantoína (8,8%). Conclusão: Os dados encontrados indicam que as taxas de resistência bacteriana às quinolonas nas ITU são elevadas e que a terapia empírica adotada pela maioria dos médicos entrevistados vai contra esse perfil de resistência. Por outro lado, foi encontrada uma baixa resistência à nitrofurantoína, demonstrando a necessidade de elaboração de protocolo local de tratamento. (39)1553 www.rbmfc.org.br ARTIGOS DE PESQUISAS Infecciones del tracto urinário adquiridas en la comunidad en Divinópolis, Brasil: evaluación del perfil de la resistencia bacteriana y la gestión clínicaObjective: To analyze the bacterial resistance profile and clinical management of urinary tract infections (UTI) in the city of Divinópolis, Brazil. Methods: This is a cross-sectional descriptive study which data were obtained from the positive urine cultures performed in the first half of 2015 in Municipal Laboratory of Microbiology and from interviews with doctors working in the municipal primary care assistance of Divinópolis. Results: Out of the urocultures evaluated (N=802), 72.8% isolated Escherichia coli, 38.6% of them being resistant to trimethoprim-sulfamethoxazole, 33.0% to norfloxacin, 31.8% to ciprofloxacin and 9.0% to nitrofurantoin. In the total amount of 57 physicians interviewed, 73.5% usually order laboratory test for acute uncomplicated cystitis. The antimicrobials of first choice in the empirical treatment of UTI, according to the interviewed, were norfloxacin (56.1%), trimethoprim-sulfamethoxazole (19.3%), ciprofloxacin (10.5%) and nitrofurantoin (8.8%). Conclusion: The data obtained indicate that the rates of bacterial resistance to quinolones are high in UTI and that the empirical therapy adopted by the majority of interviewees goes against this resistance profile. On the other hand, a low resistance to nitrofurantoin was found, which demonstrates the need to elaborate a local treatment protocol. declaram não haver.
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