• Gastón Astroza, Alejandro Miranda, Santiago Escobar-Urrejola, Joaquín García, Mario Orio, Sebastián Urrutia, Nelson Muñoz, Roberto Bernatuil, Bruno Vivaldi, Gonzalo Rubio, Emilio Sánchez, Maximiliano Narváez, and Felipe Aguila.
• Departamento de Urología, Pontificia Universidad Católica de Chile, Santiago, Chile.
• Rev Med Chil. 2023 Sep 1; 151 (9): 119412001194-1200.

BackgroundInadequate antibiotic coverage in septic patients is associated with higher morbidity and mortality. This multicentric study reports antibiotic susceptibility in patients with ureterolithiasis-associated urosepsis, aiming to propose an optimal empirical therapy for this disease in the Chilean population.MethodsThe prospective cohort study included patients from 7 Chilean hospitals who presented with ureterolithiasis and met sepsis criteria. We analyzed demographic data, vital signs at admission, and microbiological and radiological exams. We used descriptive statistics for the analysis of collected data.ResultsInitially, the study included 119 patients; 52 met the inclusion criteria. 77% were female, with a mean age of 52. 100% of the cohort had a urine culture taken at admission, whereas 48,7% had blood cultures. Escherichia Coli was the most common microorganism (73%), followed by Proteus Mirabilis (9.6%) and Klebsiella Pneumoniae (3.9%). Only two patients presented gram-positive pathogens. 100% of gram-negative bacteria were sensible to amikacin.ConclusionThe microorganisms found in our cohort were similar to those in international reports. Since the highest level of susceptibility was for amikacin, we propose its use as empirical therapy for urosepsis associated with ureterolithiasis in Chile. It is always necessary to consider the potential nephrotoxic effects of amikacin. An association of beta-lactams and glycopeptides should be considered in patients with risk factors for enterococcal infections.

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