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

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



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.


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.


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.


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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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