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Infectio

Print version ISSN 0123-9392

Abstract

MENDEZ-FANDINO, Yardany Rafael et al. Clinical characterisation of urinary tract infections produced by extended-spectrum beta-lactamase-producing enterobacteria in Duitama (Colombia) from 2010-2015. Infect. [online]. 2017, vol.21, n.1, pp.15-18. ISSN 0123-9392.  https://doi.org/10.22354/in.v21i1.636.

Objective:

To characterise epidemiologically urinary tract infections (UTI) caused by extended-spectrum betalactamase producing (ESBL)-producing Enterobacteriaceae in Duitama (Colombia) from 2010-2015.

Methodology:

A descriptive study was conducted on ESBL isolates of pathogens associated with UTI in 2 health institutions. Sociodemographic variables, comorbidities, hospitalisations in the last year for UTI, isolated agents, empirical and directed treatment, and clinical response were recorded.

Results:

A total of 169 patients were included, with an average age of 66.01 ± 19.19; 55.62% were over 65; 59.2% were female and 73.6% were from an urban area. The most frequent comorbidities were chronic obstructive pulmonary disease in 26%; 24.9% had diabetes and 16% had chronic kidney disease, with a Charlson index of 4.43 ± 2.61. Some 61.6% had been hospitalised in the last year due to UTIs. The most common isolated agents were Escherichia coli in 94.7% and Klebsiella spp. in 2.4%. The empirical treatments used were ampicillin/sulbactam in 15%, ciprofloxacin in 29.6% and nitrofurantoin in 10.7%. Regarding directed treatment, 36.7% do not have des-escalation, 32% of patients were treated with ertapenem and 8.9% were treated with piperacillin/tazobactam. Mortality was 5.9% and the average hospital stay was 7.24 ± 7.43 days.

Conclusion:

Regional data are similar to global data. Empirical treatment should be revaluated, since current guidelines do not recommend the use of ciprofloxacin. In addition, better tracking of ESLB is needed due to flaws in empirical treatment for a large percentage of the strains.

Keywords : Epidemiology; Urinary tract infection; Microbial drug resistance; Betalactamase.

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