URINARY-TRACT INFECTIONS IN THE CITY OF FLORENCE - EPIDEMIOLOGIC CONSIDERATIONS OVER A 20-YEAR PERIOD

Our study of significant bacteriurias indicated that the worldwide shi ft in the etiology of infections also holds true for the Florence area . In a twenty-year period (1970-1990), we noted a decreased frequency of Gram-negative bacilli, particularly of the family Enterobacteriacea e, and a significant increase of Gram-positive cocci in urinary patien ts. This finding was observed both in hospital and in community-acquir ed cases in the male sex and only in nosocomial bacteriurias in the fe male sex. There was a reduced isolation of ''classic'' urinary pathoge ns such as Proteus mirabilis: its prevalence in hospital-acquired urin ary tract infection (UTI) decreased from 16% in 1970 to 5% in 1990 bot h in males and in females. On the other hand, we noted an increase of ''difficult'' microorganisms such as enterococci and methicillin-resis tant staphylococci, particularly in the male sex; in 1970 enterococci were occasionally isolated in males both from hospital and from commun ity-acquired UTIs (3% and 5%, respectively), whereas in 1990, on the c ontrary, they were encountered much more frequently (19% in both cases ).