Increasing prevalence of antimicrobial resistance in urinary tract infections of neurological patients, Seoul, South Korea, 2007-2016

Hye-Rim Shin; Jangsup Moon; Han Sang Lee; Seon Jae Ahn; Tae-Joon Kim; Jin-Sun Jun; Jun-Sang Sunwoo; Soon-Tae Lee; Keun-Hwa Jung; Kyung-Il Park; Ki-Young Jung; Manho Kim; Sang Kun Lee; Kon Chu

doi:10.1016/j.ijid.2019.05.002

Increasing prevalence of antimicrobial resistance in urinary tract infections of neurological patients, Seoul, South Korea, 2007-2016

Int J Infect Dis. 2019 Jul:84:109-115. doi: 10.1016/j.ijid.2019.05.002. Epub 2019 May 8.

Authors

Affiliations

¹ Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea.
² Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea; Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea.
³ Department of Neurology, Ajou University School of Medicine, Suwon, South Korea.
⁴ Department of Neurology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea.
⁵ Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Soonchunhyang University Seoul Hospital, Seoul, South Korea.
⁶ Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Seoul National University Healthcare System Gangnam Center, Seoul, South Korea.
⁷ Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea. Electronic address: stemcell.snu@gmail.com.

PMID: 31077804
DOI: 10.1016/j.ijid.2019.05.002

Abstract

Objectives: Urinary tract infection (UTI) is a common medical complication experienced by patients with neurologic diseases. In this study, we established the microbial etiologies of UTI, and resistances to antibiotics in UTI as well as determining which appropriate empirical antibiotics should be used to treat UTI in neurological patients.

Designs and methods: We retrospectively reviewed microbial etiologies and antimicrobial resistance among patients experiencing UTI events in the neurology ward of Seoul National University Hospital from 2007 to 2016.

Results: The total number of UTI events observed was 301, and Klebsiella pneumoniae was the most common pathogen observed in UTIs. But in catheter-associated UTI (CAUTI), Enterococcus species were the most prevalent pathogens. Susceptibility to commonly-prescribed antibiotics decreased over 10 years, indicating increased antibiotic resistance in pathogens associated with UTI. ESBL-producing K. pneumoniae increased significantly, while increases of MDR K. pneumoniae, ESBL-producing E. coli, and VRE were not observed.

Conclusions: The worldwide trend of increasing drug-resistant pathogens should be considered, and further studies on antibiotics resistance in UTI are needed. These data will greatly assist physicians when they select antibiotics to treat UTIs in neurological patients.

Keywords: Anti-bacterial agents; Bacterial; Drug resistance; Microbiological phenomena; Urinary tract infections.

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents / therapeutic use*
Drug Resistance, Bacterial
Female
Humans
Klebsiella pneumoniae / drug effects
Male
Microbial Sensitivity Tests
Middle Aged
Prevalence
Retrospective Studies
Seoul
Time Factors
Urinary Tract Infections / drug therapy*
Young Adult

Substances

Anti-Bacterial Agents