Antimicrobial resistance in community-acquired urinary tract infections: results from the Korean Antimicrobial Resistance Monitoring System

The Korean Antimicrobial Resistance Monitoring System was established and the first nationwide surveillance of bacterial uropathogens was conducted during the period from January 2008 to June 2009. With the cooperation of 34 medical centers throughout South Korea, a total of 1994 strains belonging to clinically relevant bacterial uropathogens were collected from patients with community-acquired urinary tract infections (UTIs). To compare with past data, understand a trend of antimicrobial resistance, and ultimately determine new regimens for empirical treatment of uncomplicated cystitis, the antimicrobial susceptibilities against Escherichia coli in uncomplicated cystitis to commonly prescribed drugs were investigated. In uncomplicated cystitis, the most prevalent causative organism was E. coli (72.7%), followed by Enterococcus faecalis (10.7%) and Klebsiella pneumoniae (3.5%). Among E. coli isolates from acute uncomplicated cystitis, 38.5% were susceptible to ampicillin, 80.7% to amoxicillin/clavulanate, 67.3% to trimethoprim/sulfamethoxazole, 74.6% to ciprofloxacin, 77.5% to levofloxacin, 86.0% to cefazolin, 86.1% to cefuroxime, 93.6% to cefpodoxime, 94.7% to ceftriaxone, 99.5% to amikacin, 80.9% to tobramycin, and 76.6% to gentamicin. An increasing tendency of resistance to ciprofloxacin (24.8%) has been observed compared with the similar studies in 2006 (23.4%) and 2002 (15.2%) from patients with uncomplicated cystitis. These data provide much needed information on the prevalence of antimicrobial resistance in community-acquired UTIs in South Korea and will be a useful reference for future periodic surveillance studies.