Document Type : Original Article
Authors
1
Department of Pharmaceutical Sciences, Faculty of Pharmacy, Federal University of Juiz de Fora, Brazil Postgraduate Program in Collective Health, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
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
Department of Internal Medicine, Faculty of Medicine, Federal University of Juiz de Fora, 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
Abstract
Background: This study aimed 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.
Materials & Methods: This 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 multivari
ate logistic regression analyses were performed to identify factors associated with MDR.
Findings: Among 1955 urine cultures analyzed, 418 (21.4%) demonstrated significant bacterial growth, with E. coli accounting for 48.3% (n=202) of the positive cultures. The highest resistance rates were to ampicillin (56.9%), ciprofloxacin (37.6%), and trimethoprim–sulfamethoxazole (35.0%), whereas the lowest resistance rates were observed to nitrofurantoin (8.3%) and fosfomycin (3.1%). MDR was identified in 71 (35.1%) E. coli isolates, among which 24 (33.8%) exhibited an extended-spectrum β-lactamase phenotype, and three (4.2%) produced carbapenemases. In the multivariate analysis, above-median age 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 surveillance of antimicrobial resistance and periodic review of empirical treatment protocols in outpatient settings.
Keywords
Subjects
Infection Epidemiology and Microbiology