Resistencia antimicrobiana en Escherichia coli uropatógena (UPEC) en Latinoamérica: revisión sistemática.

Antimicrobial resistance in uropathogenic E. coli (UPEC) is a growing concern for urinary tract infection treatment in Latin America. This study examined resistance profiles, associated mechanisms, and antimicrobials retaining greater in vitro activity across the region. We conducted a systematic review of studies published from 2021 to 2025 in PubMed/MEDLINE, Scopus, SciELO, LILACS, and Google Scholar. Of 93 records identified, 30 full-text reports were assessed and 17 articles met the inclusion criteria. Frequent resistance to ampicillin, fluoroquinolones, trimethoprim-sulfamethoxazole, and cephalosporins was observed, together with extended-spectrum beta-lactamase production and multidrug-resistant strains. Nitrofurantoin, fosfomycin, amikacin, and carbapenems retained greater in vitro activity in several settings, although patterns differed by country and population. These findings support stronger microbiological surveillance, regular updates to treatment guidelines using local data, and prudent empirical antibiotic use in settings with high resistance rates.