Document Type : Original Article
Authors
1
Postgraduate Program in Collective Health, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil Department of Pharmaceutical Sciences, Faculty of Pharmacy, Federal University of Juiz de Fora
2
Department of Pharmaceutical Sciences, Faculty of Pharmacy, Federal University of Juiz de Fora, Brazil.
3
Postgraduate Program in Collective Health, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
4
Postgraduate Program in Health at the Federal University of Juiz de Fora, Minas Gerais, Brazil
5
Postgraduate Program in Collective Health, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil. Embrapa Dairy Cattle, Brazilian Agricultural Research Company, Juiz de Fora, Minas Gerais, Brazil
6
Postgraduate Program in Collective Health, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
7
Universidade Federal de Juiz de Fora
Abstract
Objectives: To investigate the antimicrobial resistance profile and the occurrence of multidrug resistance (MDR) among Escherichia coli isolates recovered from urine cultures of outpatients attending a public teaching hospital in Brazil and to assess the association of sex and age with MDR.
Methods: A cross-sectional study was conducted based on a retrospective analysis of urine cultures collected from outpatients between January and December 2024. Descriptive statistics were applied, and univariate and multivariate logistic regression analyses were performed to identify factors associated with MDR
Results: Among the 1,955 urine cultures analyzed, 418 (21.4%) demonstrated significant bacterial growth, with E. coli accounting for 202 (48.3%) of the positive isolates. Resistance rates were highest for ampicillin (56.9%), ciprofloxacin (37.6%), and trimethoprim–sulfamethoxazole (35.0%), whereas low resistance rates were observed for nitrofurantoin (8.3%) and fosfomycin (3.1%). MDR was identified in 71 (35.1%) isolates, among which 24 (33.8%) exhibited an extended-spectrum β-lactamase phenotype and three (4.2%) produced carbapenemases. In the multivariate analysis, age above the median was independently associated with MDR (adjusted OR = 2.27; 95% CI: 1.24–4.14)
Conclusion: A substantial proportion of E. coli isolates from community-acquired urinary tract infections presented multidrug resistance, particularly among older patients. These findings emphasize the importance of local antimicrobial resistance surveillance and the periodic review of empirical treatment protocols in outpatient settings.
Keywords
Subjects
Infection Epidemiology and Microbiology