RESUMEN
AIM: To investigate the spectrum of gram-negative agents causing acute and recurrent cystitis in outpatients and sensitivity of uropathogenic E. coli to antibacterial drugs; to compare drug resistance of uropathogenic E. coli isolated in Russia and other countries. MATERIAL AND METHODS: The spectrum of gram-negative bacteria was identified in 299 cases of acute and recurrent cystitis in Moscow, Smolensk and Novosibirsk. 271 E. coli uropathogenic strains were examined according to CA-SFM and NCCLS criteria for sensitivity to ampicilline, gentamycin, trimetoprim, co-trimoxasol, nitrofurantoine, nalidixic acid, pipemidine acid, norfloxacine, ciprofloxacine, nitroxoline. RESULTS: E. coli, K. pneumoniae, K. oxytoca, P. mirabilis, P. vulgaris caused acute and recurrent cystitis in 90.6, 6.4, 1, 1.7, 0.3% of the examinees, respectively. For Moscow relative agents were: E. coli (80.8%), K. pneumoniae (13.1%), K. oxytoca (2.3%), P. mirabilis (3.1%), P. vulgaris (0.7%). In Smolensk E. coli, K. pneumoniae, P. mirabilis were isolated in 96.3, 2.5 and 1.2%, respectively. E. coli occurred in 100% of Novosibirsk cases. Mean Russian values of the resistance to ampicilline, gentamycin, trimetoprim, co-trimoxasol, nitrofurantoin, nalidixic acid, pipemidine acid, norfloxacine, ciprofloxacine, nitroxoline were the following: 33.3, 5.9, 20.3, 18.4, 2.9, 5.5, 4.4, 2.6, 2.6 and 94.1%, respectively. Resistance to 2 and more drugs was registered in 18.4% of E. coli strains. CONCLUSION: Cystitis in women was in most cases caused by E. coli. The highest resistance among uropathogenic strains E. coli was observed to nitroxoline, ampicilline, trimetoprim and co-trimoxasole; maximal antibacterial activity against uropathogenic E. coli was shown by fluoroquinolones (norfloxacin and ciprofloxacin).
Asunto(s)
Farmacorresistencia Microbiana , Bacterias Gramnegativas/efectos de los fármacos , Infecciones por Bacterias Gramnegativas/microbiología , Pacientes Ambulatorios , Infecciones Urinarias/microbiología , Antibacterianos , Quimioterapia Combinada/uso terapéutico , Femenino , Bacterias Gramnegativas/aislamiento & purificación , Infecciones por Bacterias Gramnegativas/tratamiento farmacológico , Infecciones por Bacterias Gramnegativas/epidemiología , Humanos , Incidencia , Pruebas de Sensibilidad Microbiana , Pacientes Ambulatorios/estadística & datos numéricos , Federación de Rusia/epidemiología , Infecciones Urinarias/tratamiento farmacológico , Infecciones Urinarias/epidemiología , Orina/microbiologíaRESUMEN
Infections of the urinary tract (IUT) belong to the most prevalent infectious diseases. Acute cystitis is the most frequent symptom of uncomplicated IUT. The main agents of IUT are gram-negative enterobacteria, mainly Escherichia coli (80%). The agents of uncomplicated IUT are the least resistant (5%) to fluoroquinolones (norfloxacin and ciprofloxacin). The duration of antibiotic therapy for acute cystitis is determined predominantly by risk factors: a 7-day course is recommended for cases with risk factors and a 3-day one for cases without risk factors. In acute pyelonephritis antibiotic therapy should be longer (10-14 days). Preventive therapy is recommended for patients with frequent relapses of IUT.