Abstract

"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."

• Keywords: Urinary tract infection, Cystitis, Ciprofloxacin, Antimicrobial resistance