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Choe and Lee: National Trends of Antimicrobial Resistance in Uncomplicated Cystitis
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Urogenit Tract Infect 2016;11(1):7-11.

Published online: 20 April 2016

DOI: https://doi.org/10.14777/uti.2016.11.1.7

National Trends of Antimicrobial Resistance in Uncomplicated Cystitis

Hyun-Sop Choe, Seung-Ju Lee

Department of Urology, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea

Correspondence to: Seung-Ju Lee http://orcid.org/0000-0003-0072-8010 Department of Urology, The Catholic University of Korea, St. Vincent's Hospital, 93 Jungbu-daero, Paldal-gu, Suwon 16247, Korea Tel: +82-31-249-7473, Fax: +82-31-253-0949 E-mail: lee.seungju@gmail.com

Received 1 September 2015       Revised 29 September 2015       Accepted 7 October 2015

Copyright © 2016 Korean Association of Urogenital Tract Infection and Inflammation

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

Acute uncomplicated cystitis is a common bacterial infection of the urinary bladder in women. Antibiotic resistance against Escherichia coli is increasing nationwide in Korea; therefore, we reviewed the local available data regarding acute cystitis. The recently determined susceptibilities of E. coli to gentamicin, fluoroquinolone, 3rd generation cephalosporin, and amikacin are 75%, 85–95%, 95%, and 97%, respectively. The resistance rates of E. coli to trimethoprim/sulfamethoxazole, fluoroquinolone, and even 3rd generation cephalosporin are higher in Korea compared with other countries, however, the studies that determined those resistance rates included data collected at tertiary referral hospitals, which may have been overestimated. Continuous monitoring of antibiotic resistance and opportune establishment and revision of treatment guidelines are required for the optimal management of acute cystitis.

Keywords: Cystitis, Antibiotic resistance, Community-acquired infections

References

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Fig. 1.
Schematization of Table 2. TMP/SMX: trimethoprim/sulfamethoxazole.
uti-11-7f1.tif

Table 1.
Causative organisms of community-acquired urinary tract infections in Korea
Causative organisms Lee et al. [5] (2009) Shin et al. [6] (2008) Lee et al. [7] (2002) Wie et al. [8] (2001) Kim et al. [9] (1996–1999) Min [10] (1995–1997)
APN Cystitis APN Cystitis APN APN Cystitis APN
Escherichia coli 153 (76.1) 1,071 (72.7) 661 (91.9) 191 (79.9) 120 (92.3) 34 (70.8) 41 (64.1) 191 (88.0)
Klebsiella pneumoniae 9 (4.4) 52 (3.5) 15 (2.1) 6 (2.5) 6 (4.3) 2 (4.2) 2 (3.1) 8 (3.7)
Proteus species     1 (0.1) 7 (2.8) 2 (1.5) 1 (2.1)    
Enterococcus species 13 (6.5) 158 (10.7) 11 (1.6) 9 (3.8)   5 (10.4) 6 (9.3) 7 (3.2)
Streptococcus species   44 (3.0) 7 (1) 1 (0.4)     9 (14.1)  
Others 26 (13.0) 149 (10.1) 24 (3.3) 25 (10.5) 2 (1.5) 6 (12.5) 6 (9.4) 11 (5.1)
Total number 201 1,474 719 239 130 48 64 217

Values are presented as number (%).

APN: acute pyelonephritis.

Table 2.
Antimicrobial susceptibility of uropathogens (Escherichia coli) of uncomplicated urinary tract infection cases
Susceptibility (%) Lee et al. [5] (2009) Shin et al. [6] (2008) Lee et al. [7] (2002) Wie et al. [8] (2001) Kim et al. [9] (1996–1999) Min [10] (1995–1997)
APN Cystitis APN Cystitis APN APN Cystitis APN
Amikacin 99.3 99.5 99.5 99 99.2 100 95.5 97.5
Gentamicin 75.8 76.6 74.4 81.7 81.5 75.7 81.8 68.5
Ampicillin 31.4 38.5 37 37.2 – 64.9 54.1 17.2
Cefuroxime 86.9 86.1 – – 98.5 – – 95.5
Ciprofloxacin 81.7 74.6 84.1 84.8 93.1 83.8 86.4 86.5
Ceftriaxone 88.2 94.7 95.4 99.5 99.2 – – 98.1
TMP/SMX 64.7 67.3 67.2 61.3 63.8 67.6 47.7 34.7
Isolate no. 153 1,071 660 191 130 37 44 191

APN: acute pyelonephritis, TMP/SMX: trimethoprim/sulfamethoxazole.

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