Korean J Urol.  2011 Aug;52(8):554-559. 10.4111/kju.2011.52.8.554.

Prevalence of and Risk Factors for Levofloxacin-Resistant E. coli Isolated from Outpatients with Urinary Tract Infection

• Jang WH
• Yoo DH
• Park SW

• KMID: 1988961
• DOI: http://doi.org/10.4111/kju.2011.52.8.554

Abstract

PURPOSE
Levofloxacin has been widely used because of its broad spectrum and excellent penetration of the prostate. But levofloxacin-resistant Escherichia coli (E.coli) has been reported all over the world. We analyzed the annual levofloxacin resistance of E. coli and its risk factors.
MATERIALS AND METHODS
From 2005 to 2009, we retrospectively analyzed patients who had undergone a urine analysis and a urine culture at the Outpatient Section of the Department of Urology of Kwangju Christian Hospital. Among them, we chose 509 patients infected by E. coli and evaluated the resistance rate to levofloxacin and its risk factors.
RESULTS
The annual rates of levofloxacin resistance of E. coli were 29.49% in 2005, 26.51% in 2006, 40.21% in 2007, 43.20% in 2008, and 31.75% in 2009. A close correlation with the resistance rate was shown in cases that had underlying neurogenic bladder (p=0.002, odds ratio [OR]=4.236), a history of ciprofloxacin (p<0.001, OR=3.753) and levofloxacin (p<0.001, OR=2.996) administration for at least 48 hours in the past year, urolithiasis (p=0.003, OR=3.317), and older age (p<0.001, OR=1.027).
CONCLUSIONS
This study from 2005 to 2009 showed that the levofloxacin resistance rates of E. coli were high at over 25%. The risk factors that affected the levofloxacin resistance rates of E. coli were underlying neurogenic bladder, ciprofloxacin administration history, urolithiasis, levofloxacin administration history, and older age. Levofloxacin should be prescribed cautiously in patients with these risk factors until the pathogen is identified.

Keyword

Drug resistance; Fluoroquinolones; Risk factors

MeSH Terms

Ciprofloxacin
Drug Resistance
Escherichia coli
Fluoroquinolones
Humans
Odds Ratio
Ofloxacin
Outpatients
Prevalence
Prostate
Retrospective Studies
Risk Factors
Urinary Bladder, Neurogenic
Urinary Tract
Urinary Tract Infections
Urolithiasis
Urology
Ciprofloxacin
Fluoroquinolones
Ofloxacin

Figure

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  FIG. 1 Variations in sales amounts of ciprofloxacin and levofloxacin in South Korea. 4Q: the fourth quarter.

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