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The Korean Antimicrobial Resistance Monitoring System for Complicated Urinary Tract Infections: A Prospective Multicenter Observational Study Conducted by the Korean Association of Urogenital Tract Infection and Inflammation
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Seong Hyeon Yu, Seung Il Jung, Donghoon Lim, Jeong Woo Lee, Seung-Ju Lee, Hong Chung, Mi-Mi Oh, Jing Bong Choi, Jae Hung Jung, Hee Jo Yang, KAUTII Investigators
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Urogenit Tract Infect 2026;21(1):15-25. Published online April 30, 2026
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DOI: https://doi.org/10.14777/uti.2550040020
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 Abstract
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- Purpose
This study aimed to report antimicrobial resistance (AMR) patterns among patients with complicated urinary tract infection (cUTI) using data from the Korean Antimicrobial Resistance Monitoring System (KARMS).
Materials and Methods: In this prospective, multicenter, observational surveillance study, data from patients diagnosed with cUTI between January 2023 and September 2025 were retrieved from the KARMS database. Demographic characteristics, uropathogen distribution, and antimicrobial susceptibility profiles of representative pathogens were analyzed.
Results
Data from a total of 698 patients were collected in the KARMS database. The mean patient age was 68.94±15.95 years. The numbers of patients with healthcare-associated UTI and recurrent UTI were 171 (24.5%) and 240 (34.4%), respectively. Escherichia coli was the most frequently identified uropathogen (n=356, 51.1%). Regarding antimicrobial susceptibility, 92.9% of isolates were susceptible to fosfomycin, 75.5% to nitrofurantoin, 47.2% to ciprofloxacin, 63.3% to cefotaxime, 80.6% to piperacillin/tazobactam, and 98.8% to ertapenem. The rate of extended-spectrum beta-lactamase positivity was 45.2% (166 of 367) and was significantly higher in pyelonephritis and urosepsis (62.3% and 62.5%, p=0.002), healthcare-associated UTI (58.6%, p=0.040), and recurrent cUTI (53.2%, p=0.028). Fluoroquinolone resistance was significantly more common in female patients (49.1%, p=0.021) and in healthcare-associated UTI (57.9%, p=0.014). Piperacillin/tazobactam resistance was significantly higher in patients with urosepsis (37.0%, p=0.004), in tertiary hospitals (17.2%, p=0.019), and in healthcare-associated UTI (26.4%, p=0.001). In addition, third-generation cephalosporin resistance was significantly higher in secondary hospitals than in tertiary hospitals (43.5% vs. 33.3%, p=0.041).
Conclusions
These data provide current information on uropathogen distribution and AMR patterns in cUTI in South Korea. Continued surveillance and ongoing data accumulation through KARMS will support evidence-based strategies for optimal antimicrobial therapy and AMR mitigation.
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Ciprofloxacin Resistant and Extended Spectrum β-Lactamase Producing Escherichia Coli Cultured in a Urosepsis Patient by Urinary Stone Complicated Acute Pyelonephritis
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Donghoon Lim, Haepyoung Seo, Chul-Sung Kim
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Korean J Urogenit Tract Infect Inflamm 2009;4(1):100-103. Published online April 30, 2009
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Abstract
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- "Urosepsis in adults comprises approximately 25% of all sepsis cases and in most cases is due to complicated urinary tract infections (UTIs). Escherichia Coli (E. coli) and other Enterobacteriaceae can be expected to be the predominant pathogens in the patients with community acquired urosepsis, which needs appropriate empirical antimicrobial treatment. However, recently, increasing worldwide prevalence of quinolone-resistant E. coli and/or extended spectrum β-lactamase (ESBL) producing E.coli has made clinicians difficult in treating UTIs. Lately, we experienced a urosepsis patient by quinolone-resistant and ESBL producing E. coli, with urinary stone complicated acute pyelonephritis, who didn't show any response to empirical antibiotics or appropriate bacterial culture results. We report this case to emphasis the importance of multi-drug resistance bacteria such as quinolone resistant and ESBL producing E. coli, although it is known widely, but easy to pass over."
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Bilateral Genital Tuberculosis with Unusual Presentation
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Donghoon Lim, Chul-Sung Kim
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Korean J Urogenit Tract Infect Inflamm 2008;3(1):120-123. Published online April 30, 2008
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Abstract
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- Genital tuberculosis occurs in the epididymis most frequently but rarely involves the testis. Also, bilateral involvement of genital tuberculsis is rare. Diagnosis of tuberculous epididymitis and testicular involvement of tuberculosis can be challenging because they can be misdiagnosed as acute epididymitis and testicular tumor. Herein, we present a case of bilateral genital tuberculosis with unusual presentation which mimicked acute epididymitis and testicular tumor in a 72 year old male.
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