High Microbiological Spectrum Resistance Rates in Urine Isolates from Jalisco, Mexico. A Retrospective Study and Literature Review

Background: Urinary tract infections (UTIs) are a major public health  problem worldwide. In Latin America, most UTIs are treated without  bacteriological identifiation. Our aim was to examine resistance rates  to commonly prescribed antibiotics, focusing on cases from Jalisco,  Mexico; and additionally to conduct a review of the literature to search  for resistance patterns in other countries of Latin America. Methods: Retrospective analysis of urine cultures from ambulatory  and hospitalized patients taken from Nov 2012-Nov 2013; susceptibi lity testing and minimal inhibitory concentration (MIC) was done by  microdilution methodology. For literature search, we reviewed diffe  rent data bases and included papers in English and Spanish, published  from 2007-2014, representative from the Latin America region. Results: We obtained 1.206 consecutive samples from outpatient  and inpatient facilities, including adult and pediatric subjects. The  most frequent isolate in all groups was ESBL-producing E. coli with  high resistance rates for ampicillin, TMP-SMX, and ciproflxacin. In  the literature review we found 15 papers related to resistance rates  of commonly prescribed antibiotics. Conclusions: The information summarized in this article supports  the fiding that resistance rates to commonly prescribed antimicrobial  agents are increasing worldwide. As such, this study challenges the  rationale behind empiric use of antibiotics, emphasizing the need,  whenever possible, to perform urine cultures before initiating antimi crobial treatment.