• Isabel Losada, Gema Barbeito, Fernando García-Garrote, Begoña Fernández-Pérez, Alberto Malvar, Xurxo Hervada, Grupo de trabajo de la SOGAMIC para el estudio de las resistencias en Galicia, and Grupo de trabajo de la SOGAMIC Sociedad Gallega de Microbiología para el estudio de las resistencias.
• Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, España. Electronic address: isabel.losada.castillo@sergas.es.
• Aten Primaria. 2020 Aug 1; 52 (7): 462-468.

ObjectiveEscherichia coli (E. coli) is responsible for the majority of community urinary tract infections. The objective of the study is to know the sensitivity spectrum of E. coli in urinary tract infections to be able to recommend the appropriate empirical antibiotic treatment.DesignCross-sectional, multicentric, retrospective study.LocationGalician 8 public hospitals, practically the entire population of Galicia (Spain).Participants43,137 outpatients with urinary tract infection due to E. coli isolated in urine in 2016/2017.Main MeasurementsAnalyzed variables: demographic, minimum inhibitory concentration and interpretation of sensitivity according to CLSI criteria and resistance mechanisms. The antibiotics studied were: ampicillin, amoxicillin-clavulanic acid, ciprofloxacin, cefotaxime, cefepime, gentamicin, nitrofurantoin, fosfomycin, cotrimoxazole, imipenem and ertapenem. The identification and sensitivity were made mainly by automated methods.ResultsThe percentages of non-sensitivity of E. coli isolates were: ampicillin 49.2%, amoxicillin-clavulanic acid 17.8%, cefotaxime 6.7%, cefepime 5.7%, ertapenem 0.04%, imipenem 0.05%, gentamicin 9,1%, ciprofloxacin 26.2%, fosfomycin 3.3%, nitrofurantoin 2.4% and cotrimoxazole 23.9%. The non-sensitivities were higher in men and as age increases. Six percent of E. coli were producers of extended-spectrum beta-lactamases.ConclusionsThe empirical treatment in Galicia for uncomplicated cystitis produced by E. coli in women continues to be nitrofurantoin and fosfomycin. In men under 15 years of age, fosfomycin is indicated and in men older than 15 years, treatment in our environment should include culture and administer a 3rd generation oral cephalosporin empirically. Cotrimoxazole and ciprofloxacin are not recommended as empirical treatment because of their high resistance rates.Copyright © 2020 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

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