Aspects of urinary tract infections and antimicrobial resistance in hospitalized urology patients in Asia: 10-Year results of the Global Prevalence Study of Infections in Urology (GPIU)

J Infect Chemother. 2018 Apr;24(4):278-283. doi: 10.1016/j.jiac.2017.11.013. Epub 2017 Dec 29.

Abstract

Objectives: To assess Asian data from Global Prevalence Study on Infections in Urology (GPIU study) which has been performed more than 10 years.

Methods: Seventeen Asian countries participated in the GPIU study between 2004 and 2013. Data for these countries were collected from the web-based GPIU database. The point prevalence of urinary tract infections (UTI) and antimicrobial susceptibility of representative pathogens were analysed for Asian geographic regions.

Results: A total of 6706 patients (5271 male, 1435 female) were assessed during the study period, and 659 patients were diagnosed with a UTI (9.8%). Of these UTI patients, 436 were male and 223 were female. Mean patient age was 54.9 ± 19.3 years. Pyelonephritis and cystitis were the most common clinical diagnoses, representing 30.7% and 29.9% of patients, respectively. Escherichia coli was the most frequently identified uropathogen (38.7%). For the patients with urinary tract infection, cephalosporins were the most frequently used antibiotics (34.4%), followed by fluoroquinolones (24.1%), aminoglycosides (16.8%). Fluoroquinolone resistance was relatively high (ciprofloxacin 54.9%, levofloxacin 39.0%), and cephalosporin resistance 42% (42.5-49.4%). Of the antibiotics evaluated, uropathogens had maintained the highest level of susceptibility to amikacin and imipenem (24.9% and 11.3% resistance rates, respectively).

Conclusion: Uropathogens in many Asian countries had high resistance to broad-spectrum antibiotics. Knowledge of regional and local resistance data and prudent use of antibiotics are important for proper management of UTI in Asian countries.

Keywords: Antibiotic resistance; Asia; Prevalence; Surveillance; Urinary tract infections.

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Asia / epidemiology
  • Cystitis / diagnosis
  • Cystitis / drug therapy
  • Cystitis / epidemiology
  • Cystitis / microbiology
  • Drug Resistance, Multiple, Bacterial*
  • Escherichia coli / drug effects
  • Escherichia coli / pathogenicity
  • Escherichia coli Infections / diagnosis
  • Escherichia coli Infections / drug therapy
  • Escherichia coli Infections / epidemiology
  • Escherichia coli Infections / microbiology
  • Female
  • Hospitals / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Pyelonephritis / diagnosis
  • Pyelonephritis / drug therapy
  • Pyelonephritis / epidemiology
  • Pyelonephritis / microbiology
  • Urinary Tract Infections / diagnosis
  • Urinary Tract Infections / drug therapy
  • Urinary Tract Infections / epidemiology*
  • Urinary Tract Infections / microbiology*

Substances

  • Anti-Bacterial Agents