Perfil de sensibilidad y resistencia antibiótica en mujeres diabéticas tipo 2 con infección del tracto urinario por Escherichia Coli. Hospital Vicente Corral Moscoso, Cuenca 2014-2016

Abstract

Background: The National Institute of Statistics and Censuses (INEC) establishes diabetes mellitus as the principal cause of female mortality with 2.538 women (9%) per year and a rate of 25,8% for each 100.000 habitants. Diabetic women have higher risk for the development of urinary tract infections and its therapeutic management is an essential aspect for the patient prognosis. Objective: To determinate the sensitivity profile and antibiotic resistance in type 2 diabetic women with urinary tract infection caused by Escherichia coli. “Vicente Corral Moscoso” Hospital, Cuenca, 2014 – 2016. Methodology: Descriptive and retrospective research. The universe was formed by 235 clinical records of diabetic women with urinary tract infection admitted to the "Vicente Corral Moscoso" Hospital from January 2014 to December 2016. The information was collected in forms; data were processed using the SPSS V.15 program, applying descriptive statistic (frequency, percentage and mean), which were represented in graphics and tables. Results: Patients of ≥ 65 years old were more affected by urinary tract infections (47, 2%), as well as the ones who belong to the urban area (68,1%). Glycosylated hemoglobin values superior to 7% belong to the 66,8% of the cases. Pharmacological treatment for diabetes mellitus was insulin in the majority of patients (59,6%). The microorganism showed more resistance for ampicilin/sulbactam (74,5%), ciprofloxacin (73,4%) and trimethoprim/sulfamethoxazole (65, 2%); and showed greater percentage of susceptibility to fosfomycin (93,3%) and nitrofurantoin (89,9%). 26% of urine cultures had extended-spectrum-beta-lactamase (ESBL)-producing E. coli, presenting 100% of susceptibility to carbapenems. Conclusions: The most affected ones were diabetics who belong to the elderly group and also the ones who had poor glycemic control. The highest bacterial resistance was for ampicillin/sulbactam, ciprofloxacin and trimethoprim/sulfamethoxazole, whereas the major sensitivity was for fosfomycin and nitrofurantoin. Extended-Spectrum Beta-Lactamase (ESBL) - producing E. coli exhibited higher susceptibility to imipenem and meropenem