Antimicrobial resistance in community-acquired urinary tract infections: results from the Korean Antimicrobial Resistance Monitoring System

Lee, Seung‐Ju; Lee, Dong Sup; Choe, Hyun Sop; Shim, Bong Suk; Kim, Chul Sung; Kim, Min Eui; Cho, Yong Hyun

doi:10.1007/s10156-010-0178-x

Cited by 48 publications

(29 citation statements)

References 10 publications

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“…Recently, the increase in ESBL-producing E. coli has become a global concern [9,10,11]. In the 2010 report of the Korean Antimicrobial Resistance Monitoring System, the incidence of ESBL-producing E. coli was 9.5% (116/1226) in community- acquired infections and 25% (9/36) in hospital-acquired infections [12]. In another report of the Korean Association of Urogenital Tract Infection and Inflammation, the prevalence of ESBL-producing E. coli that were isolated from female patients with uncomplicated cystitis was stated as 11.8% [13].…”

Section: Discussionmentioning

confidence: 99%

Clinical Efficacy of Ertapenem for Recurrent Cystitis Caused by Multidrug-Resistant Extended-Spectrum β-Lactamase-ProducingEscherichia coliin Female Outpatients

2014

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PurposeTo evaluate the clinical outcomes of ertapenem administered as an outpatient parenteral antibiotic therapy for intractable cystitis caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli.Materials and MethodsWe retrospectively reviewed a case series of 3 years of therapeutic experience with ertapenem for intractable recurrent cystitis caused by ESBL-producing E. coli. Ertapenem 1 g/d was parenterally administered to the patients on an outpatient basis until the acquisition of symptomatic improvement and negative conversion of urine culture. Demographic and clinical characteristics of patients, antimicrobial resistance, and clinical response data were analyzed from the patients' medical records.ResultsDuring the course of this study, a total of 383 patients were diagnosed with cystitis, and 24 of them showed ESBL-producing E. coli (6.26%). The mean treatment duration of all patients was 8.5 days. The early clinical and microbiological cure rates 0 to 7 days after the end of treatment were 91.7% (22/24) and 90.9% (20/22), respectively. The late clinical and microbiological cure rates 4 to 6 weeks after the end of treatment were 72.2% (13/18) at both time points.ConclusionsParenteral ertapenem treatment can be an effective and well-tolerated treatment option for intractable recurrent cystitis by multidrug-resistant ESBL-producing E. coli.

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Section: Discussionmentioning

confidence: 99%

Clinical Efficacy of Ertapenem for Recurrent Cystitis Caused by Multidrug-Resistant Extended-Spectrum β-Lactamase-ProducingEscherichia coliin Female Outpatients

2014

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“…More exceptional-but recapitulating the Hong Kong data [35]-is a 2006 multicenter survey finding of ESBLs in 11.8% of E. coli from uncomplicated cystitis [51]. A subsequent study of isolates collected in 2008-2009 found a lower (6.4%) rate of cephalosporin resistance in E. coli from cystitis, although the authors noted that ciprofloxacin resistance continued to increase from 15.2% in 2002 to 23.4% in 2006 and 24.8% in 2008-2009 [52]. …”

Section: Anti-gram-negative Antibioticsmentioning

confidence: 94%

Current Epidemiology and Growing Resistance of Gram-Negative Pathogens

Livermore

2012

Korean J Intern Med

331

237

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In the 1980s, Gram-negative pathogens appeared to have been beaten by oxyimino-cephalosporins, carbapenems, and fluoroquinolones. Yet these pathogens have fought back, aided by their membrane organization, which promotes the exclusion and efflux of antibiotics, and by a remarkable propensity to recruit, transfer, and modify the expression of resistance genes, including those for extended-spectrum β-lactamases (ESBLs), carbapenemases, aminoglycoside-blocking 16S rRNA methylases, and even a quinolone-modifying variant of an aminoglycoside-modifying enzyme. Gram-negative isolates -both fermenters and non-fermenters-susceptible only to colistin and, more variably, fosfomycin and tigecycline, are encountered with increasing frequency, including in Korea. Some ESBLs and carbapenemases have become associated with strains that have great epidemic potential, spreading across countries and continents; examples include Escherichia coli sequence type (ST)131 with CTX-M-15 ESBL and Klebsiella pneumoniae ST258 with KPC carbapenemases. Both of these high-risk lineages have reached Korea. In other cases, notably New Delhi Metallo carbapenemase, the relevant gene is carried by promiscuous plasmids that readily transfer among strains and species. Unless antibiotic stewardship is reinforced, microbiological diagnosis accelerated, and antibiotic development reinvigorated, there is a real prospect that the antibiotic revolution of the 20th century will crumble.

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“…Urinary tract infections (UTIs) are common with an annual global incidence of at least 250 million cases; and Escherichia coli is the most common pathogen (1). Trimethoprim/sulfamethoxazole (SMX) has been used successfully to treat community-acquired UTI (CA-UTI) previously, but fluoroquinolones (FQ) are currently being used more frequently as the first-line treatment because of the increasing resistance to SMX among uropathogens (2).…”

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confidence: 99%

Susceptibility of Escherichia coli from Community-Acquired Urinary Tract Infection to Fosfomycin, Nitrofurantoin, and Temocillin in Korea

Seo

Kim

et al. 2014

J Korean Med Sci

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With increase of multi-drug resistant Escherichia coli in community-acquired urinary tract infections (CA-UTI), other treatment option with a therapeutic efficacy and a low antibiotic selective pressure is necessary. In this study, we evaluated in vitro susceptibility of E. coli isolates from CA-UTI to fosfomycin (FM), nitrofurantoin (NI), temocillin (TMO) as well as trimethoprim-sulfamethoxazole (SMX), ciprofloxacin (CIP) and cefepime (FEP). The minimal inhibitory concentrations were determined by E-test or agar dilution method according to the Clinical and Laboratory Standards Institute guidelines, using 346 E. coli collected in 12 Korean hospitals from March 2010 to February 2011. FM, NI and TMO showed an excellent susceptibility profile; FM 100% (346/346), TMO 96.8% (335/346), and NI 99.4% (344/346). Conversely, resistance rates of CIP and SMX were 22% (76/346) and 29.2% (101/349), respectively. FEP still retained an activity of 98.5%. In Korea, NI and TMO in addition to FM are a good therapeutic option for uncomplicated CA-UTI, especially for lower UTI.Graphical Abstract

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Antimicrobial resistance in community-acquired urinary tract infections: results from the Korean Antimicrobial Resistance Monitoring System

Cited by 48 publications

References 10 publications

Clinical Efficacy of Ertapenem for Recurrent Cystitis Caused by Multidrug-Resistant Extended-Spectrum β-Lactamase-ProducingEscherichia coliin Female Outpatients

Clinical Efficacy of Ertapenem for Recurrent Cystitis Caused by Multidrug-Resistant Extended-Spectrum β-Lactamase-ProducingEscherichia coliin Female Outpatients

Current Epidemiology and Growing Resistance of Gram-Negative Pathogens

Susceptibility of Escherichia coli from Community-Acquired Urinary Tract Infection to Fosfomycin, Nitrofurantoin, and Temocillin in Korea

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