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Treatment and Prevention of Catheter-Associated Urinary Tract Infections
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Seung Hyuk Yim, U-Syn Ha, Dong Wan Sohn, Seung-Ju Lee, Chang Hee Han, Choong Bum Lee, Yong-Hyun Cho
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Korean J Urogenit Tract Infect Inflamm 2009;4(2):159-169. Published online October 31, 2009
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 Abstract
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- Urinary tract infections (UTIs) represent the second most often observed infectious diseases in community, following the respiratory tract infections. Approximately 40% of nosocomial infections originate in the urinary tract; about 80% of urinary tract infections is related to urinary catheterization. The duration of catheterization is the most important risk factor for development of UTIs and additional risk factors include female sex, diabetes mellitus, renal function impairment, lack of antimicrobial therapy, and not maintaining a closed drainage system. There are many methods for preventing catheter-associated urinary tract infections (CAUTI); (i) an indwelling catheter should be introduced under antiseptic conditions; (ii) urethral trauma should be minimized by the use of adequate lubricant and the smallest possible catheter; (iii) the catheter system should remain closed; and (iv) the duration of catheterization should be minimal. Antimicrobial urinary catheters can prevent or delay the onset of CAUTI, but the effect on morbidity is not known. Antibiotic treatment is recommended only in symptomatic infection (bacteremia, pyelonephritis, epididymitis, prostatitis), but systemic antimicrobial treatment of asymptomatic CAUTI is only recommended in the following circumstances; (i) patients undergoing urological surgery or implantation of prosthesis; (ii) treatment may be part of a plan to control nosocomial infection due to a particularly virulent organism prevailing in a treatment unit; (iii) patients who have a high risk of serious infectious complications; and (iv) infections caused by strains causing a high incidence of bacteremia.
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Expression of Multidrug Resistance of Ciprofloxacin-Resistant Escherichia coli from Outpatients with Uncomplicated Cystitis
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Choong Bum Lee, Dae Haeng Cho, Moon Soo Chung, Seung-Ju Lee
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Korean J Urogenit Tract Infect Inflamm 2009;4(1):80-85. Published online April 30, 2009
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Abstract
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- "Purpose: Currently, the prevalence of fluoroquinolone-resistant isolates of uropathogens has been reported to be increasing over time in some centers in Korea. We determined the in vitro susceptibilities of collected ciprofloxacin-resistant urine isolates of Escherichia coli (E. coli) from outpatients to other oral antimicrobial agents used for the treatment of acute cystitis. Materials and Methods: From January 2007 to December 2008, a total of 150 ciprofloxacin-resistant E. coli isolates from urine specimens from outpatients with acute cystitis were collected from 5 university hospitals in Korea. Clinical and Laboratory Standards Institute-specified broth microdilution testing was performed with amoxicillin/clavulanate, ampicillin, cefuroxime, cefpodoxime, and trimethoprim/sulfamethoxazole (TMP/SMX). Results: Ciprofloxacin-resistant E. coli isolates were frequently resistant to ampicillin (84.6% of isolates) and TMP/SMX (63.4%); concurrent resistance to amoxicillin/clavulanate (10.0%) or cefpodoxime (6.6%) was less common. Only 6.6% of isolates was resistant to ciprofloxacin alone; concurrently resistant to one (28.7%), two (42.7%), three (10.7%), four (9.3%), or five (2.0%) other oral antimicrobial agents, most commonly ampicillin and TMP/SMX. Conclusions: Ciprofloxacin-resistant E. coli isolates from urine were frequently multidrug resistant in Korea. Close attention is required to monitor fluoroquinolone resistance patterns and the association of multidrug resistance with fluoroquinolone resistance in uropathogens."
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KAUTI
