The Distribution Trend and Antimicrobial Susceptibility of Uropathogens in Taiwan: Retrospective Analysis of a 10-Year Study

Overview

Journal J Acute Med

Date 2023 Jul 19

PMID 37465830

Authors

Szu-Cheng Huang

Chung-Hsien Chaou

Chip-Jin Ng

Shi-Ying Gao

Chen-June Seak

Chih-Huang Li

Affiliations

Soon will be listed here.

Abstract

: The prevalence and antimicrobial susceptibility of uropathogens can vary with time and geographical location. Empirical antibiotic treatment is frequently started before the urine culture reports are received; thus, the correct selection of antibiotics is imperative, as inappropriate use could increase resistance rates. This study evaluates the distribution trends and antimicrobial susceptibility of common uropathogens in Taiwan to help predict causative pathogens, prevent overly broad antibiotic use, and guide the optimal prescription of empirical antibiotic therapy to improve prognosis. : This retrospective study extracted 5,672,246 urine culture sample data, including outpatient, emergency, and inpatient departments, during 2007-2017 from the Chang Gung Research Database. We examined the trend and susceptibility of uropathogens. : The three leading microorganisms were , , and . . was more common among females (42.7%) than males (24.7%), while was more common among males (10.2%) than females (4.42%). and were highly susceptible to carbapenems, followed by aminoglycosides. Nevertheless, an increased antimicrobial resistance trend was observed in cephalosporins and quinolones. : This study establishes and as the predominant uropathogens. Age and gender of patients result in distribution variations of uropathogens, but geographical location does not. In addition, occurs more in the sample of elderly and that too among males. Overall, this study could help clinicians choose appropriate antibiotics to treat urinary tract infections per the prevalent uropathogens and local antimicrobial susceptibility patterns.

Citing Articles

Bacterial Diversity and Antibiotic Resistance Patterns of Community-Acquired Urinary Tract Infections in Mega Size Clinical Samples of Egyptian Patients: A Cross-Sectional Study.

Tarek A, Abdalla S, Dokmak N, Ahmed A, El-Mahdy T, Safwat N Cureus. 2024; 16(1):e51838.

PMID: 38327928 PMC: 10849261. DOI: 10.7759/cureus.51838.

References

Zilberberg M, Nathanson B, Sulham K, Shorr A . Antimicrobial Susceptibility and Cross-Resistance Patterns among Common Complicated Urinary Tract Infections in U.S. Hospitals, 2013 to 2018. Antimicrob Agents Chemother. 2020; 64(8). PMC: 7526848. DOI: 10.1128/AAC.00346-20. View

Jean S, Coombs G, Ling T, Balaji V, Rodrigues C, Mikamo H . Epidemiology and antimicrobial susceptibility profiles of pathogens causing urinary tract infections in the Asia-Pacific region: Results from the Study for Monitoring Antimicrobial Resistance Trends (SMART), 2010-2013. Int J Antimicrob Agents. 2016; 47(4):328-34. DOI: 10.1016/j.ijantimicag.2016.01.008. View

Yi-Te C, Shigemura K, Nishimoto K, Yamada N, Kitagawa K, Sung S . Urinary tract infection pathogens and antimicrobial susceptibilities in Kobe, Japan and Taipei, Taiwan: an international analysis. J Int Med Res. 2019; 48(2):300060519867826. PMC: 7593667. DOI: 10.1177/0300060519867826. View

Chiu C, Lin T, Wu R, Yang Y, Hsiao P, Lee Y . Etiologies of community-onset urinary tract infections requiring hospitalization and antimicrobial susceptibilities of causative microorganisms. J Microbiol Immunol Infect. 2017; 50(6):879-885. DOI: 10.1016/j.jmii.2016.08.008. View

Kung C, Ku W, Lee C, Fung C, Kuo S, Chen T . Epidemiology and risk factors of community-onset urinary tract infection caused by extended-spectrum β-lactamase-producing Enterobacteriaceae in a medical center in Taiwan: a prospective cohort study. J Microbiol Immunol Infect. 2013; 48(2):168-74. DOI: 10.1016/j.jmii.2013.08.006. View

Yang Y, Ku C, Lin J, Shang S, Chiu C, Yeh K . Impact of Extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae on the outcome of community-onset bacteremic urinary tract infections. J Microbiol Immunol Infect. 2011; 43(3):194-9. DOI: 10.1016/S1684-1182(10)60031-X. View

Soltani R, Ehsanpoor M, Khorvash F, Shokri D . Antimicrobial susceptibility pattern of extended-spectrum β-lactamase-producing bacteria causing nosocomial urinary tract infections in an Iranian referral teaching hospital. J Res Pharm Pract. 2014; 3(1):6-11. PMC: 4078647. DOI: 10.4103/2279-042X.132703. View

Gupta K, Hooton T, Naber K, Wullt B, Colgan R, Miller L . International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011; 52(5):e103-20. DOI: 10.1093/cid/ciq257. View

Ahmed I, Sajed M, Sultan A, Murtaza I, Yousaf S, Maqsood B . The erratic antibiotic susceptibility patterns of bacterial pathogens causing urinary tract infections. EXCLI J. 2015; 14:916-25. PMC: 4669912. DOI: 10.17179/excli2015-207. View

10.

Pragasam A, Veeraraghavan B, Nalini E, Anandan S, Kaye K . An update on antimicrobial resistance and the role of newer antimicrobial agents for . Indian J Med Microbiol. 2018; 36(3):303-316. DOI: 10.4103/ijmm.IJMM_18_334. View

11.

Rizvi Z, Jamal A, Malik A, Zaidi S, Rahim N, Arshad D . Exploring Antimicrobial Resistance in Agents Causing Urinary Tract Infections at a Tertiary Care Hospital in a Developing Country. Cureus. 2020; 12(8):e9735. PMC: 7489772. DOI: 10.7759/cureus.9735. View

12.

Magliano E, Grazioli V, Deflorio L, Leuci A, Mattina R, Romano P . Gender and age-dependent etiology of community-acquired urinary tract infections. ScientificWorldJournal. 2012; 2012:349597. PMC: 3351074. DOI: 10.1100/2012/349597. View

13.

Liu H, Hung Y, Lin H, Liu H, Lee J, Wu Y . Antimicrobial susceptibility of clinical Enterobacteriaceae isolates at the emergency department in a regional hospital: A threat of extended spectrum beta-lactamase-producers among nursing home residents. J Microbiol Immunol Infect. 2015; 49(4):584-90. DOI: 10.1016/j.jmii.2015.10.001. View

14.

Shariff V A A, Shenoy M S, Yadav T, M R . The antibiotic susceptibility patterns of uropathogenic Escherichia coli, with special reference to the fluoroquinolones. J Clin Diagn Res. 2013; 7(6):1027-30. PMC: 3708190. DOI: 10.7860/JCDR/2013/4917.3038. View

15.

Hsu Y, Chang S, Lin C, Lin H, Lai H, Kuo C . Clinical characteristics and prediction analysis of pediatric urinary tract infections caused by gram-positive bacteria. Sci Rep. 2021; 11(1):11010. PMC: 8155007. DOI: 10.1038/s41598-021-90535-6. View

16.

Chen H, Tain Y, Kuo H, Hsu C . Trends in Antimicrobial Susceptibility of Isolates in a Taiwanese Child Cohort with Urinary Tract Infections between 2004 and 2018. Antibiotics (Basel). 2020; 9(8). PMC: 7460002. DOI: 10.3390/antibiotics9080501. View

17.

Bischoff S, Walter T, Gerigk M, Ebert M, Vogelmann R . Empiric antibiotic therapy in urinary tract infection in patients with risk factors for antibiotic resistance in a German emergency department. BMC Infect Dis. 2018; 18(1):56. PMC: 5787273. DOI: 10.1186/s12879-018-2960-9. View

18.

Lagunas-Rangel F . Antimicrobial susceptibility profiles of bacteria causing urinary tract infections in Mexico: Single-centre experience with 10 years of results. J Glob Antimicrob Resist. 2018; 14:90-94. DOI: 10.1016/j.jgar.2018.03.004. View

19.

Tseng M, Lo W, Lin W, Teng C, Chu M, Wang C . Changing trend in antimicrobial resistance of pediatric uropathogens in Taiwan. Pediatr Int. 2008; 50(6):797-800. DOI: 10.1111/j.1442-200X.2008.02738.x. View

20.

Balkhi B, Mansy W, Alghadeer S, Alnuaim A, Alshehri A, Somily A . Antimicrobial susceptibility of microorganisms causing Urinary Tract Infections in Saudi Arabia. J Infect Dev Ctries. 2019; 12(4):220-227. DOI: 10.3855/jidc.9517. View