Vol.64 No.6 November 2016
Survey of isolated bacteria and antimicrobial susceptibility in patients with acute uncomplicated cystitis according to age
Department of Urology, Abiko Toho Hospital, 1851-1 Abiko, Abiko city, Chiba, Japan
Abstract
Purpose:
The purpose of this study was to investigate the frequency of isolated bacteria, transitions in antimicrobial susceptibility, and differences in antimicrobial susceptibility according to age in patients with acute uncomplicated cystitis between 2012 and 2014 at Abiko Toho Hospital.
Samples and Methods:
Isolated bacteria samples causing acute uncomplicated cystitis and present in urine samples at a level of more than 104 cfu/mL were examined. The background of the host and the antimicrobial susceptibility of the isolated bacteria were investigated.
Results:
A total of 304 bacteria samples were isolated (E. coli, 74.0%; Enterococcus, 7.6%; Citrobacter, 4.6%; Klebsiella and Streptococcus, 3.0%; Proteus, 2.6%; and Staphylococcus, 2.3%). The antimicrobial susceptibility was as follows: cefcapene pivoxil(CFPN-PI), 83.2%; cefazolin(CEZ), 79.9%; cefepime(CFPM), 88.2%; meropenem(MEPM), 98%; tazobactam/piperacillin(TAZ/PIPC), 98%; gentamicin(GM), 81.3%; and levofloxacin(LVFX), 84.9%. In the patients aged 40 years and younger (n=55), E. coli, gram-negative rods, and gram-positive cocci were identified in 60.0%, 63.6%, and 36.4%, respectively. In patients aged 60 years and older (n=176), E. coli and gram-negative rods were identified in 75.0% and 87.5%, respectively. The insusceptibility rate of LVFX for all isolated bacteria was 9.1% among patients aged 40 years and younger and 15.9% among patients aged 60 years and older (P=0.176). The insusceptibility rate of LVFX in E. coli was significantly higher in patients aged 60 years and above (6.1% in patients aged 40 years and younger and 19.7% in patients aged 60 years and older, P< 0.05). No difference in susceptibility between the age groups was seen for CFPN-PI, amoxicillin(AMPC), minocycline(MINO), and sulfamethoxazole-trimethoprim(ST).
Conclusion:
The frequency and antimicrobial susceptibility of isolated bacteria from patients with acute uncomplicated cystitis did not show any obvious changes between 2012 and 2014 at Abiko Toho Hospital. Quinolone-resistant E. coli was identified in about 20% of cases, but did not increase during the study period. An increase in quinolone-resistance was found among the elderly; possibly because of the accumulation of fluoroquinolone agents. Prescriptions should be given according to treatment guidelines; however, oral cephalosporin antimicrobials are desirable, especially in elderly women with acute uncomplicated cystitis caused by gram-negative rods, considering the increase in quinolone resistance.
Key word
acute uncomplicated cystitis, menopause, antimicrobials, Escherichia coli
Received
April 20, 2016
Accepted
July 4, 2016
Jpn. J. Chemother. 64 (6): 791-795, 2016
