국내에서 지역사회 급성 신우신염 원인균의 항균제 감수성 결과에
근거하여 지역사회 급성 방광염 치료 항균제를 선택할 수 있는가?
- Author(s)
- 김봉영; 김지은; 위성헌; 박선희; 조용균; 임승관; 신상엽; 염준섭; 이진서; 권기태; 이혁; 정희진;
박대원; 류성열; 정문현; 배현주
- Keimyung Author(s)
- Ryu, Seong Yeol
- Department
- Dept. of Internal Medicine (내과학)
- Journal Title
- Infection and Chemotherapy
- Issued Date
- 2012
- Volume
- 44
- Issue
- 4
- Abstract
- Background: Uncomplicated acute cystitis (CA-UAC) is one of the most common
infections treated with antibiotics in the community. However, few data on etiology
of CA-UAC and its susceptibility to antibiotics are available, primarily because, in
Korea, insurance does not allow reimbursement for microbiological evaluation of
CA-UAC. However, microbiologic data on community-acquired uncomplicated
acute pyelonephritis (CA-UAPN) are available. The objective of the study was to
evaluate the question of whether microbiologic data on CA-UAPN can be used
for treatment of CA-UAC; therefore, etiology and antimicrobial susceptibility were
compared between pathogens of CA-UAC and those of CA-UAPN.
Materials and Methods: During 2008, 538 CA-UACs and 1,265 CA-UAPNs were
recruited retrospectively from 14 hospitals (UTI research group). Microbiologic
data on etiology and susceptibility to antibiotics were collected retrospectively.
Results: Urine culture was positive in 131 CA-UACs (131/469, 27.9%) and 719
CA-UAPNs (719/1249, 57.6%). Escherichia coli was the most common pathogen
in both groups [83.2% (109/131) in CA-UAC vs. 91.9% (661/719) in CA-UAPN].
Susceptibility to common UTI regimens, such as ciprofloxacin, extended-spectrum
cephalosporins, and trimethoprim/sulfamethoxazole did not differ between urinary
pathogens of CA-UACs and CA-UAPNs, however, a significant difference was
observed in rates of resistance to ampicillin/sulbactam (16.5% vs. 42.9%, P<0.001,
respectively).
Conclusions: Rates of resistance of E. coli from CA-UAC and CA-UAPN to most
antibiotics did not differ. For proper treatment, further microbiological
evaluation
for CA-UAC is mandatory.
Key Words: Cystitis, Pyelonephritis, Antibiotic, Resistance, Comm
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