Department of Urology, St. Vincent's Hospital, The Catholic University of Korea, College of Medicine, Suwon, South Korea.
Antimicrob Agents Chemother. 2013 Nov;57(11):5384-93. doi: 10.1128/AAC.00065-13. Epub 2013 Aug 19.
This study aimed to (i) investigate the antimicrobial susceptibilities of bacteria that cause urinary tract infections (UTIs) in outpatient and inpatient settings and (ii) evaluate the risk factors for emerging antimicrobial drug resistance in UTIs in South Korea. In total, 3,023 samples without duplication were collected from females between 25 and 65 years of age who had been diagnosed with a urinary tract infection. Multicenter patient data were collected using a Web-based electronic system and then evaluated. The isolation rates of Escherichia coli, Klebsiella pneumoniae, and Enterococcus faecium in the outpatient setting were 78.1, 4.7, and 1.3%, respectively; in the inpatient setting, the isolation rates of these microorganisms were 37.8, 9.9, and 14.8%, respectively. The susceptibilities of E. coli to amikacin, amoxicillin-clavulanic acid, cefotaxime, cefoxitin, ciprofloxacin, piperacillin-tazobactam, and imipenem in the outpatient setting were 99.4, 79.8, 89.4, 92.8, 69.8, 96.9, and 100.0%, respectively; in the inpatient setting, the susceptibilities to these antibiotics were 97.8, 73.9, 73.7, 82.1, 53.6, 93.2, and 100.0%, respectively. The most unique and common risk factor for emerging antimicrobial-resistant E. coli, K. pneumoniae, and E. faecium was previous exposure to antimicrobials. On the basis of these data, the use of fluoroquinolones should be reserved until culture data are available for the treatment of UTIs in South Korea. The present study will serve as a useful reference for Far Eastern Asia.
(i)调查门诊和住院患者尿路感染(UTI)中导致感染的细菌的抗菌药物敏感性;(ii)评估韩国 UTI 中出现抗菌药物耐药性的风险因素。总共收集了 3023 份来自 25 至 65 岁之间的女性的无重复样本,这些女性均被诊断为患有尿路感染。使用基于网络的电子系统收集多中心患者数据,然后进行评估。门诊环境中,大肠埃希菌、肺炎克雷伯菌和屎肠球菌的分离率分别为 78.1%、4.7%和 1.3%;住院环境中,这三种微生物的分离率分别为 37.8%、9.9%和 14.8%。门诊环境中,大肠埃希菌对阿米卡星、阿莫西林-克拉维酸、头孢噻肟、头孢西丁、环丙沙星、哌拉西林-他唑巴坦和亚胺培南的药敏率分别为 99.4%、79.8%、89.4%、92.8%、69.8%、96.9%和 100.0%;住院环境中,这些抗生素的药敏率分别为 97.8%、73.9%、73.7%、82.1%、53.6%、93.2%和 100.0%。出现抗菌药物耐药大肠埃希菌、肺炎克雷伯菌和屎肠球菌的最独特和最常见的风险因素是之前接触过抗菌药物。基于这些数据,在获得培养数据之前,氟喹诺酮类药物应保留用于治疗韩国的 UTI。本研究将为远东地区提供有用的参考。