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Submitted: 16 May 2007 Modified: 05 September 2019
HERDIN Record #: PCHRDPC060621

Increasing antimicrobial resistance patterns of community and nosocomial uropathogens in Makati Medical Center.

 Magalit, Sheryll L,
 Oler, Maria Tarcela ,
 Tupasi, Thelma E

A descriptive study was conducted at the Makati Medical Center from December 1, 2002 to May 31, 2003 to identify the major pathogens causing community-acquired UTI (CAU) and hospital-acquired UTI (HAU) and their antibiograms A total of 220 urine culture isolates from 165 patients were reviewed. Patients were grouped as having CAU or HAU. Demographic profile, empiric treatment given, and antibiograms were collected and analyzed The CAU group consisted of 98 patients with mean age of 62 years, majority of which are female (76). The HAU group consisted of 67 patients with mean age of 65 years and also mostly female (41). The antibiotics commonly prescribed in both groups were similar, namely: fluoroquinolones (38.8 percent for both groups), ureidopenicillins and carboxypenicillins (13.3 percent for CAU vs. 18 percent for HAU), and aminopenicillins (15.3 percent for CAU, 12 percent for HAU) In CAU, organisms have notably high resistance to ampicillin (79 percent for E. coli, 96 percent for Klebsiella spp, 100 percent for Klebsiella pneumoniae, and 44 percent for P. mirabilis), cotrimoxazole (58 percent for E. coli, 67 percent for Klebsiella spp, 75 percent for Klebsiella pneumoniae, and 54 percent for P. mirabilis), and ampicillin-sulbactam and co-amoxic1av (45-54 percent for E. coli, 30 percent for Klebsiella spp, and 50 percent for Klebsiella pneumoniae). There was also high resistance to quinolones across all organisms (30-50 percent for E. coli, Klebsiella and Pseudomonas spp) except for Proteus mirabilis, which has 100 percent susceptibility. There is still very good susceptibility to aminoglycosides, cefuroxime and higher generation antibiotics. P. aeruginosa from CAU still had good susceptibility to ciprofloxacin (100 percent) In HAU, organisms had a higher resistance to ampicillin, cotrimoxazole, ampicillin-sulbactam, co-amoxic1av and quinolones (50-79 percent). Susceptibility is good for higher generation antibiotics (3rd and 4th generation cephalosporins, aminopenicillins and carbapenems). However, there is a notably high resistance of P. aeruginosa to gentamicin (64 percent) E. coli is the most commonly isolated uropathogen in the community, and P. aeruginosa in the hospital. Resistance to ampicillin, cotrimoxazole, and even beta-Iactam with beta-lactamase antibiotics of E. coli is very high at 45 to 84 percent for both CAU and HAU. Quinolones have a high resistance across all organisms in both CAU and HAU (30-50 percent) except for community acquired P aeruginosa, which still has a good susceptibility to ciprofloxacin (100 percent). Cefuroxime has good coverage (85 percent) for E. coli in CAU. Organisms causing HAU are only susceptible to higher generation antibiotics. (Author)

Publication Type
Journal
Publication Sub Type
Journal Article, Original
Title
The Philippine Journal of Microbiology and Infectious Diseases
Frequency
Quarterly
Publication Date
October-December 2004
Volume
33
Issue
4
Page(s)
143-148
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