Antibiotic Resistance of Bacteria Involved in Urinary Infections in Brazil: A Cross-Sectional and Retrospective Study

Wellington Francisco Rodrigues, Camila Botelho Miguel, Ana Paula Oliveira Nogueira, Carlos Ueira-Vieira, Tony De Paiva Paulino, Siomar De Castro Soares, Elisabete Aparecida Mantovani Rodrigues De Resende, Javier Emilio Lazo-Chica, Marcelo Costa Araújo and Carlo José Oliveira
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Wellington Francisco Rodrigues: Postgraduate Course in Health Sciences, Federal University of Triângulo Mineiro, 38061-500 Uberaba, MG, Brazil
Camila Botelho Miguel: Postgraduate Course in Health Sciences, Federal University of Triângulo Mineiro, 38061-500 Uberaba, MG, Brazil
Ana Paula Oliveira Nogueira: Institute of Genetics and Biochemistry, Federal University of Uberlandia, 38400-902 Uberlandia, MG, Brazil
Carlos Ueira-Vieira: Institute of Genetics and Biochemistry, Federal University of Uberlandia, 38400-902 Uberlandia, MG, Brazil
Tony De Paiva Paulino: Laboratório de Pesquisas do Cefores, Universidade Federal do Triângulo Mineiro, 38015-050 Uberaba, MG, Brazil
Siomar De Castro Soares: Institute of Biological and Natural Sciences, Federal University of Triângulo Mineiro, 38015-050 Uberaba, MG, Brazil
Elisabete Aparecida Mantovani Rodrigues De Resende: Clinical Hospital, Division of Endocrinology, Federal University of Triângulo Mineiro, 38025-180 Uberaba, MG, Brazil
Javier Emilio Lazo-Chica: Postgraduate Course in Health Sciences, Federal University of Triângulo Mineiro, 38061-500 Uberaba, MG, Brazil
Marcelo Costa Araújo: Clinical Pathology Service, Microbiology, Federal University of Triângulo Mineiro, 38025-180 Uberaba, MG, Brazil
Carlo José Oliveira: Institute of Biological and Natural Sciences, Federal University of Triângulo Mineiro, 38015-050 Uberaba, MG, Brazil

IJERPH, 2016, vol. 13, issue 9, 1-10

Abstract: Empirical and prolonged antimicrobial treatment of urinary tract infections caused by Escherichia coli is associated with the emergence of bacterial resistance, and not all countries have strict policies against the indiscriminate use of drugs in order to prevent resistance. This cross-sectional and retrospective study (2010–2015) aimed to evaluate the sensitivity and resistance of patient-derived E. coli to different drugs broadly used to treat urinary infections in Brazil: ampicillin + sulbactam, cephalothin, ciprofloxacin, norfloxacin, and nitrofurantoin. We obtained 1654 E. coli samples from ambulatory patients with disease symptoms of the urinary tract from a Brazilian public hospital. While all antibiotics were effective in killing E. coli to a large degree, nitrofurantoin was the most effective, with fewer samples exhibiting antibiotic resistance. We assessed the costs of generic and brand name versions of each antibiotic. Nitrofurantoin, the most effective antibiotic, was the cheapest, followed by the fluoroquinolones (ciprofloxacin and norfloxacin), ampicillin + sulbactam and, lastly, cephalothin. Finally, assessment of antibiotic resistance to fluoroquinolones over the study period and extrapolation of the data led to the conclusion that these antibiotics could no longer be effective against E. coli -based urinary infections in approximately 20 years if their indiscriminate use in empirical treatment continues.

Keywords: urinary infection; antibiotics; bacterial resistance; Escherichia coli (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2016
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