Aguinaga A, Gil-Setas A, Mazón Ramos A, Alvaro A, García-Irure J J, Navascués A, Ezpeleta Baquedano C
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An Sist Sanit Navar. 2018 Apr 30;41(1):17-26. doi: 10.23938/ASSN.0125.
Urinary tract infection (UTI) is a high prevalence infection at the community level. In order to improve the adequacy of the empirical therapy, we evaluated the etiology and the resistance pattern of the main uropathogens responsible for community acquired UTI in Navarre.
Retrospective study (2014-2016) in which we included microorganisms recovered with significant counts from samples of patients with community-acquired UTI. The global etiology and etiology according to age and sex was analyzed. Antimicrobial resistance was studied with urotopathogens isolated in 2016.
Escherichia coli was the most frequently isolated microorganism both in the population (60.8%) and in each of the groups analyzed according to age and sex. The sensitivity of E. coli was: nitrofurantoin 97.4%, fosfomycin 96.5% amoxicillin-clavulanic acid 83.8%, trimethoprim-sulfamethoxazole 68.3%, quinolones 63.4% and amoxicillin 41.9%. Pooled sensitivity shows that the sensitivity to fosfomycin was 83.4% in men <15 years, 89.4% in women <15 years and 81.9% in women between 15-65 years; and to nitrofurantoin was 86.7% in women <15 years and 82.2% in women between 15-65 years.
E. coli continues to be the most frequent microorganism in community-acquired UTI with a rate of sensitivity to fosfomycin and nitrofurantoin above 95%. The empirical treatment of UTI in our environment should not include amoxicillin, amoxicillin-clavulanic acid, trimethoprim-sulfamethoxazole or quinolones. Fosfomycin may be empirically used in the treatment of uncomplicated cystitis in men younger than 15 years and in women under 65 years, and nitrofurantoin may be used empirically in women under 65 years.
尿路感染（UTI）是社区层面一种高发性感染。为提高经验性治疗的充分性，我们评估了纳瓦拉地区社区获得性UTI主要尿路病原体的病因及耐药模式。
进行回顾性研究（2014 - 2016年），纳入从社区获得性UTI患者样本中分离出的具有显著菌数的微生物。分析总体病因以及按年龄和性别划分的病因。对2016年分离出的尿路病原体进行抗菌药物耐药性研究。
在总体人群（60.8%）以及按年龄和性别分析的各个组中，大肠杆菌都是最常分离出的微生物。大肠杆菌的敏感性为：呋喃妥因97.4%，磷霉素96.5%，阿莫西林 - 克拉维酸83.8%，甲氧苄啶 - 磺胺甲恶唑68.3%，喹诺酮类63.4%，阿莫西林41.9%。汇总敏感性显示，15岁以下男性对磷霉素的敏感性为83.4%，15岁以下女性为89.4%，15 - 65岁女性为81.9%；15岁以下女性对呋喃妥因的敏感性为86.7%，15 - 65岁女性为82.2%。
大肠杆菌仍是社区获得性UTI中最常见的微生物，对磷霉素和呋喃妥因的敏感性率高于95%。在我们的环境中，UTI的经验性治疗不应包括阿莫西林、阿莫西林 - 克拉维酸、甲氧苄啶 - 磺胺甲恶唑或喹诺酮类。磷霉素可经验性用于治疗15岁以下男性和65岁以下女性的单纯性膀胱炎，呋喃妥因可经验性用于65岁以下女性。
