Background: Urinary tract infection (UTI) is one of the most common infectious diseases at the community level. In\r\norder to assess the adequacy of the empirical therapy, the prevalence and the resistance pattern of the main\r\nbacteria responsible for UTI in the community (in Aveiro, Portugal) was evaluated throughout a ten-year period.\r\nMethods: In this retrospective study, all urine samples from patients of the District of Aveiro, in ambulatory regime,\r\ncollected at the Clinical Analysis Laboratory Avelab during the period 2000ââ?¬â??2009 were analysed. Samples with more\r\nthan 105 CFU/mL bacteria were considered positive and, for these samples, the bacteria were identified and the\r\nprofile of antibiotic susceptibility was characterized.\r\nResults: From the 155597 samples analysed, 18797 (12.1%) were positive for bacterial infection. UTI was more\r\nfrequent in women (78.5%) and its incidence varied with age, affecting more the elderly patients (38.6%). Although\r\nE. coli was, as usual, the most common pathogen implicated in UTI, it were observed differences related to the\r\nother bacteria more implicated in UTI relatively to previous studies. The bacteria implicated in the UTI varied with\r\nthe sex of the patient, being P. aeruginosa a more important cause of infection in men than in women. The\r\nincidence of the main bacteria changed over the study period (P. aeruginosa, Klebsiella spp and Providencia spp\r\nincreased and Enterobacter spp decreased). Although E. coli was responsible for more than an half of UTI, its\r\nresistance to antibiotics was low when compared with other pathogens implicated in UTI, showing also the lowest\r\npercentage of multidrug resistant (MDR) isolates (17%). Bacteria isolated from females were less resistant than those\r\nisolated from males and this difference increased with the patient age.\r\nConclusions: The differences in sex and age must be taken into account at the moment of empirical prescription\r\nof antimicrobials. From the recommended antimicrobials by the European Association of Urology guidelines, the\r\nfirst line drugs (pivmecillinam and nitrofurantoin) and the alternative antibiotic amoxicillin-clavulanic acid (AMXCLA)\r\nare appropriate to treat community-acquired UTI, but the fluoroquinolones should not be suitable to treat\r\nmale infections and the trimethoprim-sulfamethoxazole (SXT) shall not be used in the treatment of UTI at this level.
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