Frequency and antibiotic susceptibility patterns of urinary pathogens in male outpatients in Argentina

Introduction: Knowledge of the etiology and antimicrobial susceptibility patterns of uropathogens is important for determining the best treatment option. This study aimed to determine the distribution and antibiotic susceptibility patterns of bacterial strains isolated from adult male outpatients....

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Main Authors: Hugo E Villar, Mónica B Jugo, Alejandro Macan, Matias Visser, Mariana Hidalgo, Gustavo Cesar Maccallini
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2014-06-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/3766
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author Hugo E Villar
Mónica B Jugo
Alejandro Macan
Matias Visser
Mariana Hidalgo
Gustavo Cesar Maccallini
author_facet Hugo E Villar
Mónica B Jugo
Alejandro Macan
Matias Visser
Mariana Hidalgo
Gustavo Cesar Maccallini
author_sort Hugo E Villar
collection DOAJ
description Introduction: Knowledge of the etiology and antimicrobial susceptibility patterns of uropathogens is important for determining the best treatment option. This study aimed to determine the distribution and antibiotic susceptibility patterns of bacterial strains isolated from adult male outpatients. Methodology: Between November 2012 and April 2013, 3,105 community urine samples were analyzed from adult male patients who attended the Laboratorio Hidalgo, Buenos Aires, Argentina. Antimicrobial susceptibility testing was performed by the Kirby-Bauer disc diffusion method. Isolates resistant to third generation cephalosporin were tested for extended-spectrum beta-lactamase (ESBL) production using the double-disk synergy test. Results: Of the 3,105 urine samples analyzed, 791 (25.5%) had significant bacteriuria. The frequency of positive urine cultures increased significantly with patient age. Escherichia coli was isolated most frequently (47.3%), followed by Enterococcus faecalis (13.6%), and Klebsiella pneumoniae (11.9%). Gram-negative organisms represented 78.8% of urinary pathogens. The highest activities against Gram-negative bacteria were found with imipenem (99.0%), amikacin (98.1%), ertapenem (94.2%), fosfomycin (90.7%), and piperacillin-tazobactam (90.1%). The frequencies of ESBLs among E. coli, K. pneumoniae, and P. mirabilis were 15.2 %, 22.3%, and 8%, respectively. Fosfomycin, piperacillin-tazobactam, and nitrofurantoin were most effective against Gram-positive organisms. Conclusions: Fosfomycin may be an excellent option for cystitis treatment in patients without risk factors, whereas piperacillin-tazobactam is preferred for the treatment of parenchymatous UTIs, complicated UTIs, and UTIs associated with risk factors. To ensure the optimal selection of antibiotics, physicians should have access to up-to-date information about the local prevalence of antimicrobial resistance.
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spelling doaj-art-5acba6f5d2fc46b98b9d41b841c23f3d2025-08-20T02:16:14ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802014-06-0180610.3855/jidc.3766Frequency and antibiotic susceptibility patterns of urinary pathogens in male outpatients in ArgentinaHugo E Villar0Mónica B Jugo1Alejandro Macan2Matias Visser3Mariana Hidalgo4Gustavo Cesar Maccallini5Laboratorio Hidalgo, Buenos Aires, ArgentinaLaboratorio Hidalgo, Buenos Aires, ArgentinaMartinez Medical Center, Buenos Aires, ArgentinaLaboratorio Hidalgo, Buenos Aires, ArgentinaLaboratorio Hidalgo, Buenos Aires, ArgentinaLaboratorio Hidalgo, Buenos Aires, ArgentinaIntroduction: Knowledge of the etiology and antimicrobial susceptibility patterns of uropathogens is important for determining the best treatment option. This study aimed to determine the distribution and antibiotic susceptibility patterns of bacterial strains isolated from adult male outpatients. Methodology: Between November 2012 and April 2013, 3,105 community urine samples were analyzed from adult male patients who attended the Laboratorio Hidalgo, Buenos Aires, Argentina. Antimicrobial susceptibility testing was performed by the Kirby-Bauer disc diffusion method. Isolates resistant to third generation cephalosporin were tested for extended-spectrum beta-lactamase (ESBL) production using the double-disk synergy test. Results: Of the 3,105 urine samples analyzed, 791 (25.5%) had significant bacteriuria. The frequency of positive urine cultures increased significantly with patient age. Escherichia coli was isolated most frequently (47.3%), followed by Enterococcus faecalis (13.6%), and Klebsiella pneumoniae (11.9%). Gram-negative organisms represented 78.8% of urinary pathogens. The highest activities against Gram-negative bacteria were found with imipenem (99.0%), amikacin (98.1%), ertapenem (94.2%), fosfomycin (90.7%), and piperacillin-tazobactam (90.1%). The frequencies of ESBLs among E. coli, K. pneumoniae, and P. mirabilis were 15.2 %, 22.3%, and 8%, respectively. Fosfomycin, piperacillin-tazobactam, and nitrofurantoin were most effective against Gram-positive organisms. Conclusions: Fosfomycin may be an excellent option for cystitis treatment in patients without risk factors, whereas piperacillin-tazobactam is preferred for the treatment of parenchymatous UTIs, complicated UTIs, and UTIs associated with risk factors. To ensure the optimal selection of antibiotics, physicians should have access to up-to-date information about the local prevalence of antimicrobial resistance. https://jidc.org/index.php/journal/article/view/3766antimicrobial susceptibilitycommunity-acquired urinary tractempirical treatmentinfectionuropathogen
spellingShingle Hugo E Villar
Mónica B Jugo
Alejandro Macan
Matias Visser
Mariana Hidalgo
Gustavo Cesar Maccallini
Frequency and antibiotic susceptibility patterns of urinary pathogens in male outpatients in Argentina
Journal of Infection in Developing Countries
antimicrobial susceptibility
community-acquired urinary tract
empirical treatment
infection
uropathogen
title Frequency and antibiotic susceptibility patterns of urinary pathogens in male outpatients in Argentina
title_full Frequency and antibiotic susceptibility patterns of urinary pathogens in male outpatients in Argentina
title_fullStr Frequency and antibiotic susceptibility patterns of urinary pathogens in male outpatients in Argentina
title_full_unstemmed Frequency and antibiotic susceptibility patterns of urinary pathogens in male outpatients in Argentina
title_short Frequency and antibiotic susceptibility patterns of urinary pathogens in male outpatients in Argentina
title_sort frequency and antibiotic susceptibility patterns of urinary pathogens in male outpatients in argentina
topic antimicrobial susceptibility
community-acquired urinary tract
empirical treatment
infection
uropathogen
url https://jidc.org/index.php/journal/article/view/3766
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