Incidence and diversity of antimicrobial multidrug resistance profiles of uropathogenic bacteria

Abstract

The aim of this study was to assess the most frequent multidrug resistant (MDR) profiles of the main bacteria implicated in community-acquired urinary tract infections (UTI). Only the MDR profiles observed in, at least, 5% of the MDR isolates were considered. Aquarter of the bacteriawereMDR and the most common MDR profile, including resistance to penicillins, quinolones, and sulfonamides (antibiotics with different mechanisms of action, all mainly recommended by the European Association of Urology for empirical therapy of uncomplicated UTI), was observed, alone or in association with resistance to other antimicrobial classes, in themain bacteria implicated inUTI.Thepenicillin classwas included in all the frequent MDR profiles observed in the ten main bacteria and was the antibiotic with the highest prescription during the study period.The sulfonamides class, included in five of the six more frequentMDR profiles, was avoided between 2000 and 2009. The results suggest that the high MDR percentage and the high diversity of MDR profiles result froma high prescription of antibiotics but also fromantibiotic-resistant genes transmitted with other resistance determinants on mobile genetic elements and that the UTI standard treatment guidelines must be adjusted for the community of Aveiro District.