Changes of Bacterial Resistant Pattern in Adult Acute Epididymitis at a Tertiary Hospital in Recent Ten Years

Jong Jin Park; Jong Wook Kim; Jae Hyun Bae; Du Geon Moon; Mi Mi Oh

doi:10.14777/kjutii.2014.9.1.39

Journal List > Korean J Urogenit Tract Infect Inflamm > v.9(1) > 1059947

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Park, Kim, Bae, Moon, and Oh: Changes of Bacterial Resistant Pattern in Adult Acute Epididymitis at a Tertiary Hospital in Recent Ten Years

Original Article

Korean J Urogenit Tract Infect Inflamm 2014;9(1):39-43.

Published online: 17 April 2014

DOI: https://doi.org/10.14777/kjutii.2014.9.1.39

Changes of Bacterial Resistant Pattern in Adult Acute Epididymitis at a Tertiary Hospital in Recent Ten Years

Jong Jin Park, Jong Wook Kim, Jae Hyun Bae, Du Geon Moon, Mi Mi Oh

Department of Urology, Korea University Guro Hospital, Seoul, Korea

Correspondence to: Mi Mi Oh Department of Urology, Korea University Guro Hospital, 148, Gurodong-ro, Guro-gu, Seoul 152-703, Korea Tel: +82-2-2626-1310, Fax: +82-2-2626-3203 E-mail: mamah77@paran.com

Received 13 January 201410 February 2014 Accepted 10 February 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We conducted a retrospective study to investigate causative bacteria of adult epididymitis and their characteristics and resistance in the recent 10 years at a tertiary hospital.

Materials and Methods

We reviewed the medical records of 121 patients who were diagnosed with acute epididymitis from 2002 to 2012. Diagnosis was based on symptoms, physical examination, and ultrasonography. We analyzed causative organisms and changes of antibiotic resistance pattern according to time course in the recent 10 years.

Results

The most commonly detected bacteria were Pseudomonas aeruginosa and Escherichia coli. Fluouroquinolone resistance has emerged since 2006 and 50% of the patients have resistance to fluouroquinolones.

Conclusions

Quinolone resistance composes a major proportion of the causative organism. Therefore, while according to the guidelines, fluoroquinolone may be the first response for elderly men, we recommend that antibiotic resistance should be considered if fever persists, and other antibiotics could be included.

Keywords: Epididymitis, Drug resistance, microbial

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Fig. 1.

Comparison of bacteria and laboratory data by 2 years. ESBL: extended-spectrum β-lactamase–producing.

Table 1.

General characteristics of the patients

Variable	Value
Age (y)	46.1±5.6
Culture positive (n)	21 (17.3)
Hospitalization (d)	6.8±4.9
Intravenous treatment (d)	6.2±4.9
Fever (n)	30 (24.8)
Peak fever (°C)	38.2±0.8
WBC (×10³/μL, peak level)	11.6±5.7
ANC (×10³/μL, peak level)	9.0±5.8
ESR (mm/h, peak level)	33.2±28.2
CRP (mg/L, peak level)	67.4±46.9
Prostate total volume (g)	46.9±8.4
Prostate TZZ volume (g)	15.9±3.38
UA micro RBC (＞5, n)	28 (23.1)
UA micro WBC (＞5, n)	41 (33.9)

Values are presented as mean±standard deviation or number (%). WBC: white blood cell, RBC: red blood cell, ANC: absolute neutrophil count, ESR: erythrocyte sedimentation rate, CRP: C-reactive protein, TZZ: transitional zone, UA: urine analysis.

Table 2.

Frequency of isolates causing acuteepididymitis

Bacterial strains	n (%)
Pseudomonas aeruginosa	8 (38.1)
Escherichia coli	8 (38.1)
Klebsiella pneumonia	2 (9.5)
Neisseriae gonorrhoae	1 (4.8)
Enterococcus faecalis	1 (4.8)
Streptococcus agalactiae	1 (4.8)
Total	21

Table 3.

Antibiotics susceptibility of cultured organisms

	Total (n=21)			Fluoroquinolone resistance (n=10)			ESBL positive
	Susceptible	Resistant	Indeterminate	Susceptible	Resistant	Indeterminate	Susceptibility
Ampicillin	6	14	1	2	7	1	R
Amoxicillin/clavulanic acid	15	6	0	4	6	0	R
Amikacin	17	3	1	6	3	1	S
Cefotaxime	12	9	0	4	6	0	R
Ceftazidime	15	2	4	4	2	4	R
Cefepime	15	5	1	4	5	1	R
Cefoxitin	16	5	0	5	5	0	R
Imipenem	18	2	1	7	2	1	S
Meropenem	19	2	0	8	2	0	S
Gentamicin	12	9	0	4	6	0	R
Piperacillin/tazobactam	18	3	0	7	3	0	R
Trimetho/sulfamethoxazole	10	11	0	5	5	0	S
Ciprofloxacin	10	10	1	0	10	0	R
ESBL positive		1			1

ESBL: extended-spectrum β-lactamase-producing.

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