Journal List > Urogenit Tract Infect > v.14(1) > 1124661

Kim, Choi, Cho, and Min: Changes in Antibiotic Resistance of Acute Bacterial Prostatitis in a Korean Single Center

Abstract

Purpose

Acute bacterial prostatitis (ABP) is one of main infective disease in urology with various symptoms. Occurrence of complications can be minimized by appropriate treatment. We studied whether any changes in antimicrobial resistance of hospitalized ABP patients as time passed.

Materials and Methods

The study was based on retrospective study. From 2004 to 2007 as past period and 2014 to 2017 as recent period defined. Patient's ages, length of admission days, intensive care, urinalysis, strains, and resistance to antibiotics were investigated in hospitalized patients with ABP and compared between the two periods.

Results

Fifty patients of past period and 72 patients of recent period with ABP were admitted. The mean age was increased 55.5±13.2 years to 62.0±15.3 years. The infection route was mostly community-acquired. Prostate biopsy-related was decreased 7 to 1. The mean of hospital days were 7.9±4.2 days to 6.9±3.4 days. Intensive care were 5 to 7. Average length of stay intensive care was 4.2±1.3 days to 4.1±1.4 days. Urine cultures showed no significant difference from the previous studies in strains. Extended spectrum beta-lactamases producing bacteria increased 4.3% to 25.0%, and third generation cephalosporin resistance was increased 13.0% to 40.9%. Fluoroquinolone was no significant change 26.1% to 27.3%. Aminoglycosides were identified in 4.3% to 6.8% and carbapenem in 4.3% to 2.3%.

Conclusions

The mean age of hospitalized patients with ABP increased. Antimicrobial resistance did not change to fluoroquinolone, but extended spectrum beta-lactamases producing bacteria showed increased resistance to third-generation cephalosporin. Therefore, attention should be paid to the use of empirical antibiotics.

References

1. Yoon BI, Han DS, Ha US, Lee SJ, Sohn DW, Kim HW, et al. Clinical courses following acute bacterial prostatitis. Prostate Int. 2013; 1:89–93.
crossref
2. Ha US, Kim ME, Kim CS, Shim BS, Han CH, Lee SD, et al. Acute bacterial prostatitis in Korea: clinical outcome, including symptoms, management, microbiology and course of disease. Int J Antimicrob Agents. 2008; 31(Suppl 1):S96–101.
crossref
3. Brede CM, Shoskes DA. The etiology and management of acute prostatitis. Nat Rev Urol. 2011; 8:207–12.
crossref
4. Sharp VJ, Takacs EB, Powell CR. Prostatitis: diagnosis and treatment. Am Fam Physician. 2010; 82:397–406.
5. Groen J, Pannek J, Castro Diaz D, Del Popolo G, Gross T, Hamid R, et al. Summary of European Association of Urology (EAU) guidelines on neuro-urology. Eur Urol. 2016; 69:324–33.
crossref
6. Lipsky BA, Byren I, Hoey CT. Treatment of bacterial prostatitis. Clin Infect Dis. 2010; 50:1641–52.
crossref
7. Etienne M, Chavanet P, Sibert L, Michel F, Levesque H, Lorcerie B, et al. Acute bacterial prostatitis: heterogeneity in diagnostic criteria and management. Retrospective multicentric analysis of 371 patients diagnosed with acute prostatitis. BMC Infect Dis. 2008; 8:12.
crossref
8. Cho IR, Lee KC, Lee SE, Jeon JS, Park SS, Sung LH, et al. Clinical outcome of acute bacterial prostatitis, a multicenter study. Korean J Urol. 2005; 46:1034–9.
9. Park MG, Cho MC, Cho SY, Lee JW. Clinical and microbiological features and factors associated with fluoroquinolone resistance in men with community-acquired acute bacterial prostatitis. Urol Int. 2016; 96:443–8.
crossref
10. Wie SH, Kim BN, Kim JE, Park DW, Kang CI, Lee HY, et al. Guideline for the antibiotic use in urinary tract infections. Cheongju: Korea Centers for Disease Control & Prevention;2018.
11. The Korean Society of Infectious Diseases, The Korean Society for Chemotherapy, Korean Association of Urogenital Tract Infection and Inflammation, The Korean Society of Clinical Microbiology. Clinical guideline for the diagnosis and treatment of urinary tract infections: asymptomatic bacteriuria, uncomplicated & complicated urinary tract infections, bacterial prostatitis. Infect Chemother. 2011; 43:1–25.
12. Lee SJ, Lee DH, Park YY, Shim BS. A comparative study of clinical symptoms and treatment outcomes of acute bacterial prostatitis according to urine culture. Korean J Urol. 2011; 52:119–23.
crossref
13. Gashe F, Mulisa E, Mekonnen M, Zeleke G. Antimicrobial resistance profile of different clinical isolates against third-generation cephalosporins. J Pharm (Cairo). 2018; 2018:5070742.
crossref
14. Charalabopoulos K, Karachalios G, Baltogiannis D, Charalabopoulos A, Giannakopoulos X, Sofikitis N. Penetration of antimicrobial agents into the prostate. Chemotherapy. 2003; 49:269–79.
crossref
15. Naber KG, Sorgel F. Antibiotic therapy–rationale and evidence for optimal drug concentrations in prostatic and seminal fluid and in prostatic tissue. Andrologia. 2003; 35:331–5.
16. Lee Y, Lee DG, Lee SH, Yoo KH. Risk factor analysis of ciprofloxacin-resistant and extended spectrum beta-lactamases pathogen-induced acute bacterial prostatitis in Korea. J Korean Med Sci. 2016; 31:1808–13.
crossref
17. Kim JW, Oh MM, Bae JH, Kang SH, Park HS, Moon du G. Clinical and microbiological characteristics of spontaneous acute prostatitis and transrectal prostate biopsy-related acute prostatitis: is transrectal prostate biopsy-related acute prostatitis a distinct acute prostatitis category? J Infect Chemother. 2015; 21:434–7.
18. Lee SJ. Infection after transrectal ultrasound-guided prostate biopsy. Korean J Urol. 2015; 56:346–50.
crossref
19. Togo Y, Kubo T, Taoka R, Hiyama Y, Uehara T, Hashimoto J, et al. Occurrence of infection following prostate biopsy procedures in Japan: Japanese Research Group for Urinary Tract Infection (JRGU) – a multicenter retrospective study. J Infect Chemother. 2014; 20:232–7.

Table 1.
Differences between two periods of clinical manifestation in acute bacterial prostatitis patients
Parameter Past period (2004–2007, n=50) Recent period (2014–2017, n=72) Total (n=122) p-value
Mean age (y) 55.5±13.2 62.0±15.3 59.3±14.8 0.016
Hypertension 12 (24.0) 26 (36.1) 38 (31.1) 0.421
Diabetes mellitus 4 (8.0) 12 (16.7) 16 (13.1) 0.719
Cerebrovascular accident 2 (4.0) 5 (6.9) 7 (5.7) 0.138
Infection route        
Community 42 (84.0) 67 (93.1) 109 (89.3) 0.140
Hospital 1 (2.0) 4 (5.6) 5 (4.1) 0.406
Urologic manipulation 1 (2.0)a) 1 (1.4)b)  
Prostate biopsy 7 (14.0) 1 (1.4) 8 (6.6) 0.008
Hospitalization period (d) 7.9±4.2 6.9±3.4 7.3±3.8 0.146
Intensive care unit treatment        
Number 5 (10.0) 7 (9.7) 12 (9.8) >0.999
Period (d) 4.2±1.3 4.1±1.4 4.2±1.3 0.943

Values are presented as mean±standard deviation or number (%). -: not available.

a )Cystoscopy,

b) transurethral resection of the prostate.

Table 2.
Results of the detected microbial species and resistances
Parameter Past period (2004–2007) Recent period (2014–2017) Total p-value
Species
No growth 27 28 55  
Growth 23 44 67  
Escherichia coli 18 (78.3) 26 (59.1) 44 (65.7) 0.176
Klebsiella pneumoniae 3 (13.0) 4 (9.1) 7 (10.4) 0.684
Pseudomonas aeruginosa 1 (4.3) 2 (4.5) 3 (4.5) >0.999
Enterococcus 1 (4.3) 3 (6.8) 4 (6.0) >0.999
Etc.a) 0 9 (20.5) 9 (13.4)  
Resistance to antibiotics
Fluoroquinolones 6 (26.1) 12 (27.3) 18 (26.9) >0.999
Aminoglycosides 1 (4.3) 3 (6.8) 4 (6.0) >0.999
Third generation cephalosporins 3 (13.0) 18 (40.9) 21 (31.3) 0.026
Carbapenems 1 (4.3) 1 (2.3) 2 (3.0) >0.999
ESBL positive 1 (4.3) 11 (25.0) 12 (17.9) 0.045

Values are presented as number only or number (%).

ESBL: extended-spectrum beta lactamases.

a )Proteus mirabilis, Staphylococcus aureus, and Streptococcus.

TOOLS
Similar articles