Prevalence of antimicrobial resistance among uropathogens causing acute uncomplicated cystitis in female outpatients in South Korea: a multicentre study in 2006

The Korean Association of Urogenital Tract Infection and Inflammation (KAUTII) conducted a survey of the antimicrobial susceptibility patterns of uropathogens responsible for female acute uncomplicated cystitis in South Korea in 2006. KAUTII has already reported similar data in 2002, which are compared with the results of the present study. This study was carried out with the participation of 22 hospitals in South Korea. A total of 301 isolates were obtained from female outpatients with acute uncomplicated cystitis. The antimicrobial susceptibilities to commonly prescribed drugs were determined. The most prevalent causative organism was Escherichia coli (71.1%), followed by enterococci (13.0%), coagulase-negative staphylococci (5.3%) and other species of Enterobacteriaceae (10.6%). Among all Enterobacteriaceae isolates, 31.4% were susceptible to ampicillin, 52.3% to ampicillin/sulbactam, 97.6% to piperacillin/tazobactam, 78.9% to ciprofloxacin, 80.3% to gatifloxacin, 86.8% to cefazolin, 99.6% to amikacin, 80.5% to gentamicin, 81.1% to tobramycin and 73.9% to trimethoprim/sulfamethoxazole (TMP/SMX). The resistance rates of E. coli to ciprofloxacin and gatifloxacin were 23.4% and 21.8%, respectively, and 12 (11.8%) of 102 suspected strains were confirmed as producing extended-spectrum β-lactamase (ESBL). All the ESBL-producing strains were also resistant to fluoroquinolones. Enterobacteriaceae were highly susceptible to piperacillin/tazobactam and amikacin (>97%). There was a small increase in susceptibility to TMP/SMX (73.9%) compared with the same study in 2002 (62.1%). Similar to 2002, the high prevalence of resistance to ampicillin, ampicillin/sulbactam and TMP/SMX still exists. The increasing number of ESBL-producing or fluoroquinolones-resistant strains remains a serious clinical problem in South Korea.