Patrones de resistencia bacteriana en urocultivos en un hospital oncológico

Abstract

Objective. To describe the patterns of antimicrobial resis- tance of organisms isolated from urine cultures at a teach- ing oncological hospital for adult patients. Material and Methods. All strains obtained from urine cultures from 1998 to 2005 were included. Mean susceptibilities were obtained for each antimicrobial tested; nosocomial and community- acquired isolates were analyzed separately. Results. A total of 9 232 positive urine cultures were obtained (20.7%) from 44 447 samples taken. Gram negative bacteria were reported in 78.8%, Gram-positive in 13.8% and yeasts in 7.4%. Escherichia coli was the most frequently isolated bacterium (41.3%); antimicrobial resistance was higher in nosocomial isolates than in community strains (amikacin 92.4 vs. 97%, ceftazidime 83.1 vs. 95.1% and ciprofl oxacin 46.2 vs. 58.6%). Pseudomonas aeruginosa showed a greater resistance to ami- kacin and ceftazidime in nosocomial cultures compared to community-acquired bacterial cultures (55.7 vs. 66.6% and 65.5 vs. 84.8% respectively). Vancomycin-resistant entero- cocci were found in only 2.5% (3 of 119 E. faecium isolates). Conclusions.Higher bacterial resistance was observed in nosocomial cultures than in community ones. Antimicrobial resistance was found to be progressively increasing for E. coli, the most frequent pathogen isolated both in nosocomial and community infections. We consider imperative the establish- ment of an intense educational campaign for the use and control of antibiotics.