Recent Antimicrobial Susceptibilities for UropathogenicEscherichia coliin Patients with Community Acquired Urinary Tract Infections: A Multicenter Study

Abstract

Purpose: The aim of this study was to determine the prevalence and disease-specific antimicrobial susceptibility of Escherichia coli in urinary tract infections (UTIs). Materials and Methods: A total of 862 patients older than 18 years of age, who were diagnosed with UTI between January 2013 and December 2015, were included. The results of urine culture, prevalence of extended-spectrum beta lactamase (ESBL)-producing E. coli, and antimicrobial susceptibility by disease were also examined. Results: A total of 862 uropathogens were isolated. Among then, E. coli accounted for 756 (87.7%) isolates. The susceptibility rates of E. coli to the following antimicrobial agents were as follows: ampicillin 29.4%, cefazolin 70.5%, ceftazidime 75.1%, cefotaxime 75.0%, cefepime 76.2%, cefoxitin 88.8%, amoxicillin-clavulanic acid 63.6%, trimethoprim-sulfamethoxazole 60.6%, gentamicin 71.4%, ciprofloxacin 73.0%, piperacillin/tazobactam 93.9%, amikacin 99.2%, imipenem 99.1%, and ertapenem 99.3%. The frequency of ESBL-producing E. coli strains was 24.6%. The antimicrobial susceptibility of UTI varied by each disease, but without statistical significance. Conclusions: It is necessary to regularly examine the disease-specific resistance rates to determine the appropriate empiric antibiotic treatment, and the national antibiotic usage policies must be reorganized according to the data obtained from these studies.

Clinical Practice Guidelines for the Antibiotic Treatment of Community-Acquired Urinary Tract Infections

“…Resistance patterns also differ across regions [ 42 ]. In 2006, the antibiotic resistance of E. coli isolated from cystitis to ciprofloxacin was 24.6% in Seoul, 40.0% in Gyeongsang Province, 14.7% in Gyeonggi Province, and 32.1% in Chungcheong Jeolla Province [ 40 ].…”

“…However, it is difficult to apply the same cost-effectiveness concept in Korea where the standard treatment of acute uncomplicated cystitis has been changed to 3 days of empirical antibiotic treatment, and the fees for outpatient examinations, the dipstick test, and urine culture test are relatively inexpensive compared with those in the United States and Europe. According to recent data, approximately 24.6% of E. coli inducing community-acquired UTIs produce ESBL [ 42 ]. Therefore, systematic analysis is needed to investigate whether maintaining empirical antibiotic treatment without assessing antibiotic resistance of causative bacteria through a urine culture test would be appropriate in terms of treatment outcomes and prognoses.…”

Impact of Antibiotic Prescribing Patterns on Susceptibilities of Uropathogens in Children below 24 Months Old

“…The pooled prevalence of ampicillin was low-at 30.7%-in this study, with regions A and B below 30%. Similar susceptibilities to ampicillin are seen in adult studies in Korea: one study conducted during 2010-2014 showed 35.3% susceptibility to ampicillin [17], and another study from 2013-2015 showed 30.4% [18]. A meta-analysis on the global prevalence of antibiotic resistance in pediatric UTIs showed similar low susceptibilities, where UTIs caused by E. coli showed a pooled prevalence of 46.6% in OECD countries and 20.2% in non-OECD countries [9].…”

Evaluation of Extended Spectrum Beta-lactamase Production Rates and Antibiotic Susceptibilities of Escherichia coli and Klebsiella pneumoniae Strains Isolated from Urine Cultures of Outpatients

“…İstatistiksel (2,30) . Kore'de 2016 yılında yayınlanmış çok merkezli bir çalışmada toplum kökenli üriner sistem infeksiyonlarından izole edilen E.coli suşlarında GSBL pozitiflik oranı % 24.6 olarak bulunmuş (17) . Benzer özelliklere sahip, 2018 yılında Meksika'da yapılmış başka bir çalışmada ise E.coli suşlarında GSBL pozitiflik oranı % 31.3 bulunmuştur (10) .…”