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Urinary tract infection (UTI) is one of the most frequently found infections in hospital and community settings. Among the organisms, the ones resistant to multiple drugs are ever more frequent, granting limitations for the treatment. For the choice of antibiotics, it should be taken in consideration factors such as collateral effects and local sensitivity profile. Objective: To analyze the epidemiologic and resistance profile of UTI in emergency consultations of three hospitals in Caxias do Sul to determine the best therapeutic, emphasizing also the frequency and antimicrobial sensitivity of ESBL producing bacteria. Methods: Retrospective analysis of medical records and urocultures results of three hospitals in Caxias do Sul, between October 2013 and September 2014. Patients at the age of 18 and older were included, with a positive urine culture with more than 100.000 CFU that consulted in emergency department with UTI symptoms, being excluded the samples that had more than two bacteria identified. Results: 1214 positive urine samples were evaluated all derived from patients with UTI symptoms. Escherichia coli was present in 65% of the sample. For uncomplicated community acquired UTI antimicrobial resistance profile was 12.8% for nitrofurantoin, 14% for ciprofloxacine and 27% for trimethoprim-sulfamethoxazole. In complicated infections, ceftriaxone presented 11% resistance, cefalotin 22% and ciprofloxacin 38%. Among statistically significant risk factors for community acquired urinary infection caused by extended spectrum betalactamase (ESBL) producing enterobacteria are recurrent UTI, OR 24.6 CI (13.7-44.2), previous hospitalization, OR 6.04 (CI 3.729.82), previous use of antibiotics, OR 17 CI (9.02-32.14) and indwelling urinary catheter use OR 8.12 CI (4.9-13.4). Conclusion: The most frequent organism in all groups from community acquired UTI was Escherichia coli. Second and third generation cephalosporins are the antibiotics that had better cover complicated infections and nitrofurantoin is the best one for uncomplicated infection. ESBL presence was more frequent in patients with complicated UTI, having as major risk factors previous use of antibiotics, previous hospitalization and indwelling urinary catheter use, and as minor risk factors comorbidities such as cardiovascular disease, diabetes and pulmonary disease.

Perfil de Sensibilidade aos Antimicrobianos das Infecções Do Trato Urinário Adquiridas em Adultos e Idosos.