Antimicrobial Resistance of Uropathogenic Escherichia coli in Outpatient Cases at Baeza Basic Hospital, Ecuador

Abstract

Introduction: Bacterial resistance to antibiotics is one of the current major public health issues, as these compounds constitute a primary tool for controlling and treating bacterial infections.  Objective: To determine the bacterial resistance of uropathogenic Escherichia coli in outpatient individuals attending the Microbiology Laboratory of Baeza Basic Hospital (BBH) during the period January-December 2023.  Methodology: An observational, descriptive, and cross-sectional study was conducted to describe the antimicrobial resistance characteristics of uropathogenic Escherichia coli during the period January-December 2023. Results: We analyzed 169 positive urine culture results from outpatient individuals of both sexes, varying ages, with a diagnosis of urinary tract infection. The most frequently isolated microorganisms were Escherichia coli (80.1%), followed by Enterococcus faecalis (3.8%) and Proteus mirabilis (3.3%). Regarding antimicrobial resistance profiles expressed as a percentage for E. coli, they were as follows: ampicillin (70.8%), nalidixic acid (53.7%), amoxicillin + clavulanic acid (48.8%), trimethoprim + sulfamethoxazole (44.0%), and ciprofloxacin (34.3%). 12.4% of E. coli were extended-spectrum beta-lactamase (ESBL) producers. The sensitivity of E. coli to nitrofurantoin was 92.1%, ampicillin-sulbactam 90.4%, and fosfomycin 87.1%. Conclusions: The recommended empirical first-line treatment is nitrofurantoin, fosfomycin, and as second-line options, cephalexin and cefuroxime for uncomplicated urinary tract infections. Based on this information, it is proposed to develop a Clinical Guide for the treatment of uncomplicated urinary tract infections in the study areaarea.