J Korean Med Sci.  2010 Aug;25(8):1205-1209. 10.3346/jkms.2010.25.8.1205.

Risk Factors for Antimicrobial Resistance Among the Escherichia coli Strains Isolated from Korean Patients with Acute Uncomplicated Cystitis: A Prospective and Nationwide Study

• Lee G
• Cho YH
• Shim BS
• Lee SD

• KMID: 1714044
• DOI: http://doi.org/10.3346/jkms.2010.25.8.1205

Abstract

We investigated the risk factors for resistance to ciprofloxacin, cefazolin, ampicillin and co-trimoxazole in Escherichia coli isolates from urine of Korean female patients with acute uncomplicated cystitis (AUC). A total of 225 patients and their E. coli isolates were prospectively and nationwidely enrolled between May and October, 2006. All the antimicrobials did not show any differences according to the age group. A higher rate of ciprofloxacin resistance was observed in the south (OR: 3.04, 95% CI: 1.19-7.80 for Chungcheong-do & Jeolla-do; OR: 3.04, 95% CI: 1.22-7.58 for Gyeongsang-do) compared to Gyeonggi-do. Two recurrences of AUC in the past year was an important risk factor for antimicrobial resistance (ciprofloxacin; OR: 6.71, 95% CI: 1.86-24.11 and cefazolin; OR: 5.72, 95% CI: 1.20-27.25). However, the resistance to co-trimoxazole and ampicillin was not associated with any of the risk factors. This study also revealed the pattern of multi-drugs resistance in ciprofloxacin resistant E. coli strains. In conclusion, for Korean patients with two more recurrences of AUC in the past year, it is strongly recommended to perform an antimicrobial sensitivity test with a urine sample before empirical treatment.

Keyword

Ciprofloxacin; Cystitis; Resistance; Escherichia coli

MeSH Terms

Acute Disease
Adolescent
Adult
Aged
Ampicillin/pharmacology
Anti-Bacterial Agents/pharmacology
Cefazolin/pharmacology
Ciprofloxacin/pharmacology
Cystitis/*microbiology
*Drug Resistance, Bacterial
Escherichia coli/*drug effects/isolation & purification
Female
Humans
Microbial Sensitivity Tests
Middle Aged
Prospective Studies
Republic of Korea
Risk Factors
Trimethoprim-Sulfamethoxazole Combination/pharmacology

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