최근 2년간 전라남도 및 광주지역의 지역사회 획득성 요로감염에 이환된 여성 환자에서 동정된 Escherichia coli의 Ciprofloxacin 내성 패턴
The Ciprofloxacin Resistance Pattern of Escherichia coli Isolated from Female Patients with Community- acquired Urinary Tract Infection in the Jeonnam and Gwangju Region for the Recent 2-years
김경영, 김철성, 임동훈,
소속 상세정보
김경영 ( Kim Kyoung-Young )
조선대학교 의과대학 비뇨기과학교실
김철성 ( Kim Chul-Sung )
조선대학교 의과대학 비뇨기과학교실
임동훈 ( LIm Dong-Hoon )
조선대학교 의과대학 비뇨기과학교실
KMID : 0358320080490060540
Abstract
Purpose:The overuse of ciprofloxacin has recently increased the resistance of the Escherichia coli(E. coli). We studied the prevalence od the ciprofloxacin-resistant(CR) E. coli that were isolated from female patients with community-acquired urinary tract infection(CAUTI), and we demonstrated the resistant rate to other antibiotics to help physicians choose the suitable antibiotics to properly treat CAUTI.
Material and Methods : From January 2006 to December 2007, we retrospectively analyzed 910 female patients with CAUTI. Among them, we chose 387 patients infected by E. coli and we evaluated the resistance rate to ciprofloxacin and its relationship with age, the disease causing the UTI and the previous antibiotics. We also compared the resistance to ciprofloxacin with that of other antibiotics, including cephalosporin and the other antibiotics recommended by the guidelines of the Infectious Diseases Society of America(IDSA).
Results:The incidence of UTI by E. coli increased with age(p＜0.001), and it was highest in the 7th decade (59.0%). One hundred seventeen (30.2%) patients showed ciprofloxacin resistance. It was significantly related to an increased age(p=0.034), complicated UTI(p=0.04) and a previous history of antibiotic use(p=0.023). Trimethoprim/sulfamethoxazole(TMP/SMX) and fosfomycin showed similar resistance rates like ciprofloxacin; 31.8 and 28.2%, respectively. On the other hand, nitrofurantoin showed a low resistant rate of 5.7%. The resistance to cephalosporin was low in general; the lowest was cefepime(5.9%).
Conclusion: Our results imply that the empirical use of ciprofloxacin for female patients with CAUTI is questionable, and especially for patients older than 40 years old, patients with complicated UTI and patients with a previous history of antibiotic use. Nitrofurantoin and cephalosporin can be useful agents for the treatment of female CAUTI.
키워드
Ciprofloxacin; Antibiotics;Antibacterial drug;resistance;Escherichia coli;Community-acquired infections
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