Biomedical Science Letters (대한의생명과학회지)

The Korean Society for Biomedical Laboratory Sciences (대한의생명과학회)
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Trends in Pathogen Occurrence and Antimicrobial Resistance of Urinary Isolates in a Tertiary Medical Center over Ten Years: 2004~2013

  • Hong, Seung Bok (Department of Clinical Laboratory Science, Chungbuk Health & Science University) ;
  • Yum, Jong Hwa (Department of Clinical Laboratory Science, Dong-eui University) ;
  • Kim, Yong Dae (Department of Preventive Medicine, Chungbuk National University College of Medicine) ;
  • Shin, Kyeong Seob (Department of Laboratory Medicine, Chungbuk National University College of Medicine)
  • Received : 2015.05.07
  • Accepted : 2015.06.06
  • Published : 2015.06.30
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Abstract

To provide guidelines for the empirical treatment of urinary tract infections, we observed annual changes in the occurrence frequency and antimicrobial susceptibility of urinary isolates in a university hospital in the Chungbuk province, South Korea, over a period of 10 years (2004~2013). Escherichia coli (38.2%), Enterococcus faecalis (11.7%), Klebsiella pneumoniae (7.3%), Pseudomonas aeruginosa (4.3%), E. faecium (4.3%), and Staphylococcus aureus (4.1%) were commonly isolated urinary pathogens. The prevalence of E. coli, E. faecium and Streptococcus agalactiae were significantly higher in females (P < 0.001), whereas E. faecalis, P. aeruginosa and S. aureus were significantly more common in male patients (P < 0.001). E. coli mostly frequently showed resistance to ampicillin (67.94%), followed by trimethoprim/sulfamethoxazole (36.06%) and ciprofloxacin (26.84%). Over the studied time period, resistance rates of E. coli to ciprofloxacin significantly increased (20.44% to 33.55%). Moreover, extended-spectrum $\beta$-lactamase (ESBL) producing isolates also significantly increased in E. coli (4.2% to 18.3%) and K. pneumoniae (9.6% to 26.9%). In addition, the proportion of vancomycin-resistant Enterococcus facium (VRE) also increased (15.7% to 25.0%). In conclusion, over the last 10 years, the proportions of ciprofloxacin resistant E. coli and multidrug-resistant bacteria, such as ESBL and VRE have significantly increased. This trend must be strictly controlled and demonstrates the need for more updated guidelines for the treatment of urinary tract infections.

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References

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