PREVALENCE, ANTIMICROBIAL SUSCEPTIBILITY PATTERN, AND EPIDEMIOLOGY OF EXTENDED-SPECTRUM BETA-LACTAMASES (ESBL) PRODUCING BACTERIA IN URINARY TRACT INFECTIONS IN A BRAZILIAN TERTIARY CARE HOSPITAL

Autores

  • Aline Dias Paiva Universidade Federal do Triângulo Mineiro https://orcid.org/0000-0003-4234-8892
  • Julia Camargo Kabariti Universidade Federal do Triângulo Mineiro
  • Beatriz Aparecida Ferreira Universidade Federal do Triângulo Mineiro
  • Isabela Sguilla Rotta Universidade Federal do Triângulo Mineiro
  • Fernanda Machado Fonseca Universidade Federal do Triângulo Mineiro
  • Rodrigo Juliano Molina Universidade Federal do Triângulo Mineiro

DOI:

https://doi.org/10.66104/52x15240

Palavras-chave:

beta-lactamases, Escherichia coli, multirresistência, infecção urinária

Resumo

The prevalence of urinary tract infections (UTIs) caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae is increasing worldwide. A retrospective analysis of medical records was conducted for patients with UTIs admitted to a general tertiary university hospital in Brazil, over a 1-year period (2022–2023). Among 1193 UTI episodes, 179 (15%) were caused by ESBL. No significant difference in sex was observed among cases of ESBL-causing UTI, and the mean age of the patients was 55 years (range: 1–102 years). Most ESBL-producing bacteria (70%) were isolated from hospitalized patients, with an average length of hospitalization of 27.5 days. Escherichia coli and Klebsiella pneumoniae were the predominant ESBL-producing species. Over 99% of ESBL isolates demonstrated resistance to third- and fourth-generation cephalosporins and aztreonam, whereas sensitivity to amikacin and polymyxin B was observed among the majority of bacterial strains, with carbapenems being the most effective drugs. Understanding antimicrobial resistance patterns in ESBL-producing strains associated with UTIs is crucial for guiding empirical antimicrobial therapy. Prompt implementation of infection control measures and rational use of antibiotics are essential to prevent the development and dissemination of ESBL-producing bacteria.

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Referências

ALGHORAIBI, H.; ASIDAN, A.; ALJAWAWIED, R.; ALMUKHAYZIM, R.; ALSAYDAN, A.; ALAMER, E. et al. Recurrent urinary tract infection in adult patients, risk factors, and efficacy of low dose prophylactic antibiotics therapy. Journal of Epidemiology and Global Health, v. 13, p. 200–211, 2023. DOI: 10.1007/s44197-023-00105-4.

ALMEIDA, M. V. A.; CANGUSSÚ, Í. M.; CARVALHO, A. L. S.; BRITO, I. L. P.; COSTA, R. A. Drug resistance, AmpC-β-lactamase and extended-spectrum β-lactamase-producing Enterobacteriaceae isolated from fish and shrimp. Revista do Instituto de Medicina Tropical de São Paulo, v. 59, e70, 2017.

CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC). Antimicrobial resistance threats in the United States, 2021–2022. Atlanta: U.S. Department of Health and Human Services, 2023. Available from: https://www.cdc.gov/antimicrobial-resistance/data-research/threats/update-2022.html.

CLINICAL AND LABORATORY STANDARDS INSTITUTE (CLSI). Performance standards for antimicrobial susceptibility testing. 33rd ed. CLSI supplement M100. ISBN 978-1-68440-171-0 [Electronic]. USA: Clinical and Laboratory Standards Institute, 2023.

DENKEL, L. Infections caused by extended-spectrum β-lactamase-producing Enterobacterales after rectal colonization with ESBL-producing Escherichia coli or Klebsiella pneumoniae. Clinical Microbiology and Infection, v. 26, p. 1046–1051, 2020. DOI: 10.1016/j.cmi.2019.11.025.

HALABI, K.; LAHLOU, F. A.; DIAWARA, I.; EL ADOUZI, Y.; MARNAOUI, R.; BENMESSAOUD, R. et al. Antibiotic resistance pattern of extended spectrum beta lactamase producing Escherichia coli isolated from patients with urinary tract infection in Morocco. Frontiers in Cellular and Infection Microbiology, v. 11, 720701, 2021. DOI: 10.3389/fcimb.2021.720701.

HALLDÓRSDÓTTIR, A. M.; HRAFNKELSSON, B.; EINARSDÓTTIR, K.; KRISTINSSON, K. G. Prevalence and risk factors of extended-spectrum beta-lactamase producing Escherichia coli causing urinary tract infections in Iceland during 2012–2021. European Journal of Clinical Microbiology & Infectious Diseases, v. 43, n. 9, p. 1689–1697, 2024. DOI: 10.1007/s10096-024-04882-z.

KIM, Y. H.; YANG, E. M.; KIM, C. J. Urinary tract infection caused by community-acquired extended-spectrum β-lactamase-producing bacteria in infants. Journal de Pediatria (Rio de Janeiro), v. 93, n. 3, p. 260–266, 2017. DOI: 10.1016/j.jped.2016.06.009.

LAUDY, A. E.; OSIŃSKA, P.; NAMYSŁOWSKA, A.; ZAJĄC, O.; TYSKI, S. Modification of the susceptibility of gram-negative rods producing ESβLs to β-lactams by the efflux phenomenon. PLoS One, v. 10, n. 3, e0119997, 2015.

LIMA, L. M.; SILVA, B. N. M.; BARBOSA, G.; BARREIRO, E. J. β-lactam antibiotics: an overview from a medicinal chemistry perspective. European Journal of Medicinal Chemistry, v. 208, p. 112829, 2020. DOI: 10.1016/j.ejmech.2020.112829.

MANCUSO, G.; MIDIRI, A.; GERACE, E.; MARRA, M.; ZUMMO, S.; BIONDO, C. Urinary tract infections: the current scenario and future prospects. Pathogens, v. 12, n. 4, p. 623, 2023. DOI: 10.3390/pathogens12040623.

MUTEEB, G.; REHMAN, M. T.; SHAWHAN, M.; AATIF, M. Origin of antibiotics and antibiotic resistance, and their impacts on drug development: a narrative review. Pharmaceuticals (Basel), v. 16, n. 11, p. 1615, 2023. DOI: 10.3390/ph16111615.

NAUSHAD, V. A.; PURAYIL, N. K.; WILSON, G. J.; CHANDRA, P.; JOSEPH, P.; KHALIL, Z.; ZAHID, M.; KAYAKKOOL, M. K.; SHAIK, N.; AYARI, B.; CHALIHADAN, S.; ELMAGBOUL, E. B. I.; DOIPHODE, S. H. Epidemiology of urinary tract infection in adults caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae: a case-control study from Qatar. IJID Regions, v. 3, p. 278–286, 2022. DOI: 10.1016/j.ijregi.2022.05.001.

NASCIMENTO, T. L.; JUNQUEIRA, M. L.; MEURER, I. R.; GARCIA, P. G. Prevalência e perfil de suscetibilidade aos antimicrobianos de Escherichia coli em uroculturas de pacientes atendidos em um hospital de ensino. HU Revista, v. 45, n. 1, p. 13–21, 2019. DOI: 10.34019/1982-8047.2023.v49.41914.

PANTHA, S.; PARAJULI, H.; ARJYAL, C.; THAPA KARKI, S.; SHRESTHA, D. Phenotypic characterization of ESBL-producing urinary isolates of Escherichia coli and Klebsiella spp. in a tertiary care children's hospital in Nepal. Tropical Medicine and Health, v. 52, p. 20, 2024. DOI: 10.1186/s41182-024-00587-3.

PAUMIER, A.; ASQUIER-KHATI, A.; THIBAUT, S.; COEFFIC, T.; LEMENAND, O.; LARRAMENDY, S.; LECLÈRE, B.; CAILLON, J.; BOUTOILLE, D.; BIRGAND, G.; FRENCH CLINICAL LABORATORIES NATIONWIDE NETWORK. Assessment of factors associated with community-acquired extended-spectrum β-lactamase-producing Escherichia coli urinary tract infections in France. JAMA Network Open, v. 5, n. 9, e2232679, 2022. DOI: 10.1001/jamanetworkopen.2022.32679.

PULINGAM, T.; PARUMASIVAM, T.; GAZZALI, A. M.; SULAIMAN, A. M.; CHEE, J. Y.; LAKSHMANAN, M.; CHIN, C. F.; SUDESH, K. Antimicrobial resistance: prevalence, economic burden, mechanisms of resistance and strategies to overcome. European Journal of Pharmaceutical Sciences, v. 170, p. 106103, 2022. DOI: 10.1016/j.ejps.2021.106103.

RIOS NETO, M. A.; RIOS, V. M.; CORÁ, L. F.; FONSECA, M. M.; FERREIRA-PAIM, K.; FONSECA, F. M. High rates of antimicrobial resistance of ESBL-producing Enterobacteriaceae isolated from clinical samples in Northeast of Brazil. Infectious Diseases, 2017. DOI: 10.1080/23744235.2017.1381987.

SALAM, M. A.; AL-AMIN, M. Y.; SALAM, M. T.; PAWAR, J. S.; AKHTER, N.; RABAAN, A. A.; ALQUMBER, M. A. A. Antimicrobial resistance: a growing serious threat for global public health. Healthcare (Basel), v. 11, n. 13, p. 1946, 2023. DOI: 10.3390/healthcare11131946.

SOUZA, G. A. A.; PRINCE, K. A.; XAVIER, L. A.; OLIVEIRA, D. C.; ALVES, D. M.; PAULA, F. M. T.; SANTO, L. R. E. ESBL producing enterobacteria isolated from outpatients urocultures. Research, Society and Development, v. 10, n. 6, p. e37410615701, 2021. DOI: 10.33448/rsd-v10i6.15701.

TANO, Z. N.; KOBAYASHI, R. K.; CÂNDIDO, E. P.; DIAS, J. B.; PERUGINI, L. F.; VESPERO, E. C.; PAVANELLI, W. R. Susceptibility to first choice antimicrobial treatment for urinary tract infections to Escherichia coli isolates from women urine samples in community South Brazil. Brazilian Journal of Infectious Diseases, v. 26, p. 102366, 2022. DOI: 10.1016/j.bjid.2022.102366.

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Publicado

2026-03-05

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PREVALENCE, ANTIMICROBIAL SUSCEPTIBILITY PATTERN, AND EPIDEMIOLOGY OF EXTENDED-SPECTRUM BETA-LACTAMASES (ESBL) PRODUCING BACTERIA IN URINARY TRACT INFECTIONS IN A BRAZILIAN TERTIARY CARE HOSPITAL. (2026). REMUNOM, 13(01), 1-18. https://doi.org/10.66104/52x15240