High Microbiological Spectrum Resistance Rates in urine isolates from Jalisco, Mexico. A retrospective study and literature review

Abstract

Background: Urinary tract infections (UTIs) are a major public health problem worldwide. In Latin America, most UTIs are treated without bacteriological identification. Our aim was to examine resistance rates to commonly prescribed antibiotics, focusing on cases from Jalisco, Mexico; and additionally to conduct a review of the literature to search for resistance patterns in other countries of Latin America. Methods: Results:We obtained 1.206 consecutive samples from outpatient and inpatient facilities, including adult and pediatric subjects. The most frequent isolate in all groups was ESBL-producing E. coli with high resistance rates for ampicillin, TMP-SMX, and ciprofloxacin. In the literature review we found 15 papers related to resistance rates of commonly prescribed antibiotics. Conclusions:The information summarized in this article supports the finding that resistance rates to commonly prescribed antimicrobial agents are increasing worldwide. As such, this study challenges the rationale behind empiric use of antibiotics, emphasizing the need, whenever possible, to perform urine cultures before initiating antimicrobial treatment.

The Clinical Significance of High Antimicrobial Resistance in Community-Acquired Urinary Tract Infections

“…Main pathogens responsible for community-acquired uncomplicated UTIs were E. coli and ESBL-E. coli; however, the number of cases from the latter was lower compared to our own previously published findings (25% versus 68%) [11].…”

“…Common uropathogens that cause community-associated UTIs include Escherichia coli (E. coli), Klebsiella pneumoniae, and Enterococci, with the first being the primary causative agent (80%) in most studies [8]. Furthermore, among E. coli isolates, it has been found that from 1.6% to 3.9% are producers of extended spectrum-beta lactamases (ESBLs) in outpatient settings reported in France and the United States, respectively [9,10], and in our own previous experience, but with a different approach, ESBLs can be found in up to 69.5% in the outpatient setting [11].…”