Antimicrobial resistance of bacteria isolated from urinary tract infections in women

L. C. Gavriliu, G. A. Popescu

Abstract: Variability in antibiotic resistance of microorganisms commonly involved in urinary tract infections requires regularly updates to determine appropriate treatment options. we analyzed resistance profiles for 2043 non-duplicate bacterial strains isolated from urinary tract infections in women hospitalized in INBI Matei Balş between July 2008 - June 2010. The level of bacterial resistance and risk of fetal toxicity defined a limited number of therapeutic options for urinary tract infections in pregnancy. The most strains were gram negative bacilli, 88,50%, Escherichia coli accounting for 81,80% of them. 11,50% strains were gram positive cocci, 57,44% being Enterococcus faecalis. Carbapenems and nitrofurantoin remain highly active (except for gram-negative nonfermentative bacteria); piperacillin-tazobactam and 3rd-4th generation cephalosporins had relatively good activity; aminopenicillins-betalactamases inhibitors association activity was low. The preliminary results show the novelty in antimicrobial treatment recommendations in pregnancy. The antimicrobial resistance data support antimicrobial treatment recommendations in pregnancy for asymptomatic bacteriuria, cystitis (nitrofurantoin, fosfomycin) and for pyelonephritis - 3rd generation cephalosporins (carbapenems for nosocomial infections).
Keywords: urinary tract infections, antimicrobial resistance, treatment guidelines