J Korean Med Sci.  2016 Nov;31(11):1808-1813. 10.3346/jkms.2016.31.11.1808.

Risk Factor Analysis of Ciprofloxacin-Resistant and Extended Spectrum Beta-Lactamases Pathogen-Induced Acute Bacterial Prostatitis in Korea

Affiliations
  • 1Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea. yookoohan@khu.ac.kr

Abstract

The objectives of this study were to investigate risk factors and the incidence of ciprofloxacin resistance and extended-spectrum beta-lactamases (ESBL) in patients with acute bacterial prostatitis (ABP). We reviewed the medical records of 307 patients who were diagnosed with ABP between January 2006 and December 2015. The etiologic pathogens and risk factors for ciprofloxacin-resistant E. coli and ESBL-producing microbes, susceptibility to ciprofloxacin, and the incidence of ESBL in patients with ABP were described. History of prior urologic manipulation was an independent risk factor for ciprofloxacin-resistant (P = 0.005) and ESBL-producing microbes (P = 0.005). Advanced age (over 60 years) was an independent risk factor for ciprofloxacin-resistant microbes (P = 0.022). The ciprofloxacin susceptibility for Escherichia coli in groups without prior manipulation was documented 85.7%. For groups with prior manipulation, the susceptibility was 10.0%. Incidence of ESBL-producing microbes by pathogen was 3.8% for E. coli and 1.0% for Klebsiella pneumonia in the absence of manipulation group, and 20% and 33.3% in the presence of manipulation group, respectively. Initial treatment of ABP must consider patient's age and the possibility of prior manipulation to optimize patient treatment. With the high rate of resistance to fluoroquinolone, cephalosporins with amikacin, or carbapenems, or extended-spectrum penicillin with beta lactamase inhibitor should be considered as the preferred empirical ABP treatment in the patients with history of prior urologic manipulation.

Keyword

Acute Bacterial Prostatitis; Ciprofloxacin; Extended-spectrum Beta-lactamases; Risk Factors

MeSH Terms

Acute Disease
Adult
Age Factors
Aged
Amikacin/pharmacology
Anti-Bacterial Agents/pharmacology/*therapeutic use
Bacterial Infections/diagnosis/*drug therapy/microbiology
Cephalosporins/pharmacology
Ciprofloxacin/*therapeutic use
*Drug Resistance, Bacterial
Escherichia coli/drug effects/enzymology/isolation & purification
Humans
Imipenem/pharmacology
Klebsiella pneumoniae/drug effects/enzymology/isolation & purification
Male
Microbial Sensitivity Tests
Middle Aged
Multivariate Analysis
Odds Ratio
Prostatitis/*diagnosis/drug therapy/microbiology
Republic of Korea
Retrospective Studies
Risk Factors
beta-Lactamases/*metabolism
Anti-Bacterial Agents
Cephalosporins
Ciprofloxacin
Imipenem
Amikacin

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