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Chronological change of antibiotic use and antibiotic resistance in Escherichia coli causing urinary tract infections

Abstract

Overuse of antibiotics can cause the emergence of resistant bacterial strains. This study retrospectively investigated recent trends in Escherichia coli causing urinary tract infections (UTIs), focusing on antibiotic use and antibiotic susceptibilities. Patients diagnosed with UTIs caused by E. coli in Akashi Municipal Hospital between April 2004 and March 2010 were enrolled in the study. A total of 858 UTI cases were examined. Antibiotics used in our hospital during that period and the antibiotic susceptibilities of E. coli in UTI cases were assessed. We analyzed the data on a yearly basis, with the year being defined as the period from April to the following March (e.g., in this study the period from April 2004 to March 2005 represents 2004). The first 3 years (2004–2006) were compared to the last 3 years (2007–2009). The use of piperacillin, cephazolin, amikacin, oral cefotiam, and levofloxacin decreased significantly and the use of imipenem, gentamicin (GM), cefcapene, and oral minocycline (MINO) increased significantly in the last 3 years compared to the previous 3 years. The susceptibilities of MINO in complicated cystitis significantly increased and those of GM in uncomplicated pyelonephritis significantly decreased in these 3 years (2007–2009) compared to the previous 3 years (2004–2006) (P < 0.05). Additionally, extended-spectrum β-lactamase (ESBL)-producing E. coli tended to be isolated more often; this was statistically significant in the last 3 years (2007–2009) compared to the previous 3 years (2004–2006) (P < 0.05). In conclusion, we found changes in our pattern of antibiotic use associated with changes in antibiotic susceptibilities and an increase in ESBL-producing E. coli isolated from our UTI cases. Monitoring of antibiotic use and emergence of resistant strains should be continued.

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References

  1. Catal F, Bavbek N, Bayrak O, Karabel M, Karabel D, Odemis E, et al. Antimicrobial resistance patterns of urinary tract pathogens and rationale for empirical therapy in Turkish children for the years 2000–2006. Int Urol Nephrol. 2009;41:953–7.

    PubMed  Article  Google Scholar 

  2. De Francesco MA, Ravizzola G, Peroni L, Negrini R, Manca N. Urinary tract infections in Brescia, Italy: etiology of uropathogens and antimicrobial resistance of common uropathogens. Med Sci Monit 2007;13:BR136–BR144.

    Google Scholar 

  3. Gales AC, Sader HS, Jones RN, SENTRY Participants Group (Latin America). Urinary tract infection trends in Latin American hospitals: report from the SENTRY antimicrobial surveillance program (1997–2000). Diagn Microbiol Infect Dis. 2002;44:289–99.

    PubMed  Article  Google Scholar 

  4. Muratani T, Matsumoto T. Bacterial resistance to antimicrobials in urinary isolates. Int J Antimicrob Agents. 2004;24:S28–31.

    PubMed  Article  Google Scholar 

  5. Kader AA, Angamuthu K. Extended-spectrum beta-lactamases in urinary isolates of Escherichia coli, Klebsiella pneumoniae and other gram-negative bacteria in a hospital in Eastern Province, Saudi Arabia. Saudi Med J. 2005;26:956–9.

    PubMed  Google Scholar 

  6. Arslan H, Azap OK, Ergönül O, Timurkaynak F, Urinary Tract Infection Study Group. Risk factors for ciprofloxacin resistance among Escherichia coli strains isolated from community-acquired urinary tract infections in Turkey. J Antimicrob Chemother. 2005;56:914–8.

    PubMed  Article  CAS  Google Scholar 

  7. Hillier S, Roberts Z, Dunstan F, Butler C, Howard A, Palmer S. Prior antibiotics and risk of antibiotic-resistant community-acquired urinary tract infection: a case–control study. J Antimicrob Chemother. 2007;60:92–9.

    PubMed  Article  CAS  Google Scholar 

  8. Matsumoto T. Urinary tract infection. In: Kobayashi H, Kumazawa J, editors. Guideline for antibiotics treatments. 2nd ed. Tokyo: Japanese Association of Infectious Diseases and Japanese Society of Chemotherapy; 2003. p. 76–82.

    Google Scholar 

  9. Muratani T, Matsumoto T. Urinary tract infection caused by fluoroquinolone- and cephem-resistant Enterobacteriaceae. Int J Antimicrob Agents. 2006;28:S10–3.

    PubMed  Article  CAS  Google Scholar 

  10. Colodner R, Kometiani I, Chazan B, Raz R. Risk factors for community-acquired urinary tract infection due to quinolone-resistant E. coli. Infection. 2008;36:41–5.

    PubMed  Article  CAS  Google Scholar 

  11. Johnson L, Sabel A, Burman WJ, Everhart RM, Rome M, MacKenzie TD, et al. Emergence of fluoroquinolone resistance in outpatient urinary Escherichia coli isolates. Am J Med. 2008;121:876–84.

    PubMed  Article  CAS  Google Scholar 

  12. Oshiro T, Fukutomi Y, Takayanagi M, Kusaba K, Nagasawa Z, Aoki Y, et al. Antibacterial activity of oral cephems against various clinically isolated strains. Jpn J Antibiot. 2003;56:681–90.

    PubMed  Google Scholar 

  13. Yamaguchi K, Ohno A, Ishii Y, Tateda K, Iwata M, Kanda M, et al. In vitro susceptibilities to levofloxacin and various antibacterial agents of 18,639 clinical isolates obtained from 77 centers in 2004. Jpn J Antibiot. 2006;59:428–51.

    PubMed  Article  Google Scholar 

  14. Azap OK, Arslan H, Serefhanoğlu K, Colakoğlu S, Erdoğan H, Timurkaynak F, et al. Risk factors for extended-spectrum beta-lactamase positivity in uropathogenic Escherichia coli isolated from community-acquired urinary tract infections. Clin Microbiol Infect. 2010;16:147–51.

    PubMed  Article  CAS  Google Scholar 

  15. Calbo E, Romaní V, Xercavins M, Gómez L, Vidal CG, Quintana S, et al. Risk factors for community-onset urinary tract infections due to Escherichia coli harbouring extended-spectrum beta-lactamases. J Antimicrob Chemother. 2006;57:780–3.

    PubMed  Article  CAS  Google Scholar 

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Acknowledgments

We thank Drs. Kunito Yamanaka and Tomihiko Yasufuku for taking care of patients or data analyses and Gary Mawyer for English editing.

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Correspondence to Soichi Arakawa.

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Shigemura, K., Tanaka, K., Adachi, M. et al. Chronological change of antibiotic use and antibiotic resistance in Escherichia coli causing urinary tract infections. J Infect Chemother 17, 646–651 (2011). https://doi.org/10.1007/s10156-011-0241-2

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  • DOI: https://doi.org/10.1007/s10156-011-0241-2

Keywords

  • Escherichia coli
  • Urinary tract infection
  • Drug resistance
  • Antibiotic use
  • Chronological change