Objetive: Assess the direct method in the identification and susceptibility of Enterobacteriaceae in patients with significant bacteriuria treated at Hospital Madre Niño San Bartolomé. Materials and Methods: Descriptive cross-sectional study. 173 urine samples with suspected significant bacteriuria were directly processed, by inoculating the sample in differential media and two Mueller-Hinton agar plates to which was placed 10 antibiotic disks in parallel, the samples were processed according to the standardized protocol for urine culture, identifying the uropathogen through the reactions outlined in bacterial biochemistry and categorizing series of antibiotic inhibition halos breakpoints as indicated by the CLSI. Finally the results are compared for both methods and the level of agreement was calculated using the Kappa index. Results: 154 samples were analyzed and compared by the two methods for the identification, obtaining a Kappa index of 0.89, being considered as an "Almost perfect" agreement. In the case of the susceptibility test, 149 samples were compared by the two methods, obtaining a Kappa index of 0.97 for the antibiotic Trimethoprim-sulfamethoxazole, 0.82 for Ciprofloxacin, 0.94 for Gentamicin, 0.92 for Ampicillin and 0.93 for Ceftriaxone, being considered as an "Almost perfect" correlation; Cephalothin present a Kappa index of 0.64 and Amoxicillin - clavulanate 0.74 being considered as a "Substancial" agreement, as well as Nitrofurantoin Kappa index of 0.56 was considered to have as a "Moderate" agreement. On the other hand, Amikacin had a “Fair” agreement (Kappa index of 0.28). Conclusion: The direct method is a valid and reliable alternative protocol, which allows to identify the bacterial infectious agent and find the pattern of antibiotic susceptibility in less time, which can be initiated with appropriate therapy. However, it is essential to evaluate the results according to the purity and counting colonies, as well as identify and confirm the results with conventional susceptibility. Keywords: direct method, standardized method, kappa coefficient, urine.
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