Korean J Urol.  2008 Jan;49(1):66-71.

Trends in the Emergence of Ciprofloxacin-resistant Escherichia coli and the Relationship with Underlying Diseases in Patients with Urinary Tract Infection

• Chang IH
• Bang SH
• Choi NY
• Park SY
• Han JH
• Ahn SH

Abstract

PURPOSE: The increased use of antibiotics may be the main factor responsible for the development and spread of bacterial resistance. This study demonstrated the relation between quinolone use and the rate of isolating ciprofloxacin-resistant(CIPRO-R) Escherichia coli(E.coli) in patients with urinary tract infection(UTI).
MATERIALS AND METHODS
From 2001 to 2006, we determined antimicrobial use for 2,803 in terms of the defined daily dose(DDD) and the antimicrobial use density(AUD), and we surveyed the isolation rates of CIPRO-R E.coli in UTIs in both inpatients and outpatients. We also analyzed the correlation between the number of prescriptions and the resistance rates.
RESULTS
Of the 637(22.7%) CIPRO-R E.coli isolates, 297(46.6%) were from inpatients and 340(53.4%) were from outpatients. There was a statistically significant correlation between the rate of isolating CIPRO-R E.coli and the amount of quinolone use for the inpatients(r=0.815, p<0.05) as well as the outpatients(r=0.804, p<0.05). A logistic regression analysis identified previous quinolone use as the independent risk factor(odd ratio: 2.604 [95% confidence interval(CI): 1.639-4.137]) for CIPRO-R E.coli in inpatients. Also, these CIPRO-R E.coli showed low sensitivity to ampicillin and trimethoprim/sufamethoxazole(TMP/SMX) in the inpatients(10.4%, 27.3%) and outpatients(5.1%, 27.1%), respectively.
CONCLUSIONS
Our study shows a significant correlation between ciprofloxacin resistance and quinolone use, and previous quinolone use seems to be the risk factor for CIPRO-R E.coli bacteriuria. It is necessary to keep antimictrobial therapy under constant surveillance for the prevention of CIPRO-R E.coli.

Keyword

Antimicrobial resistance; Quinolones; Escherichia coli

MeSH Terms

Ampicillin
Anti-Bacterial Agents
Bacteriuria
Ciprofloxacin
Escherichia
Escherichia coli
Humans
Inpatients
Logistic Models
Outpatients
Prescriptions
Quinolones
Risk Factors
Urinary Tract
Urinary Tract Infections
Ampicillin
Anti-Bacterial Agents
Ciprofloxacin
Quinolones

Figure

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  Fig. 1. Age distribution according to the inpatients and outpatients with E.coli isolated urinary tract infection.

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  Fig. 2. Age distribution according to the inpatients and outpatients and the rates of isolating ciprofloxacin‐resistant (CIPRO-R) E.coli in urinary tract infection.

Reference

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