Antimicrobial Susceptibility Patterns in Adult Patients Hospitalized for Community-acquired Urinary Tract Infection in Tertiary Hospitals in Chile

Background: The constant increase of factors associated with the presence of resistant strains makes empirical antibiotic selection a challenge in patients hospitalized for community-acquired urinary tract infection. We characterized the type of bacteria and their antimicrobial susceptibility pattern in cultures obtained from adult patients that needed hospitalization for this disease in two tertiary hospitals in Chile. Methods: We conducted a cross-sectional study in adults hospitalized for community-acquired urinary tract infection between 2017 and 2022. A total of 830 patients were included. All patients with positive cultures were included in the analysis. Results: Escherichia coli was the most frequent infectious agent (68.1%), followed by Klebsiella spp. (17.7%) and Enterococcus faecalis (6.7%). Among Enterobacteriaceae strains, 35.2%, 19.7% and 27.2% were resistant to first, second and third-generation cephalosporin, respectively. 36.9% were resistant to ciprofloxacin and 1.8% to amikacin. Gram-positive bacteria were resistant to oxacillin and ampicillin in 25% and 18%, respectively. Conclusion: We detected a high prevalence of community-acquired urinary tract infections caused by bacteria resistant to commonly used antibiotics in adult patients that need to be hospitalized. In view of this, we believe that current medical guidelines should be reviewed and updated.