title: Pathogen occurrence and antimicrobial susceptibility of urinary tract infection cases during a 20-year period (1983-2002) at a single institution in Japan.
abstract: Urinary tract infections are one of the most common infectious diseases diagnosed in outpatients as well as in hospitalized patients. Recently, urinary tract infections have become more complicated and difficult to treat. Therefore, the present study analyzed the occurrence and antimicrobial susceptibility of uropathogens isolated at Kobe University Hospital between 1983 and 2002. This study was performed with three patient groups: urology inpatients, urology outpatients, and inpatients of other departments. During the 20-year study period, we studied 15,925 urine isolates obtained from those patients who were diagnosed with urinary tract infection. Overall, Enterococcus faecalis was the most frequently isolated pathogen, followed by Pseudomonas aeruginosa and Escherichia coli. The frequency of Staphylococcus aureus increased over time, corresponding to an increase in the occurrence of methicillin-resistant S. aureus (MRSA). In addition, the rate of isolation of Serratia marcescens also increased over time, especially among patients with urinary tract catheters. Our results demonstrate that the uropathogens isolated at a single institution have shown a trend of increasing resistance to various classes of antimicrobial agents. In addition, serious problems should be anticipated in the treatment of multidrug-resistant P. aeruginosa, fluoroquinolone-resistant E. coli, and arbekacin-resistant MRSA.
authors.affiliation: Department of Organs Therapeutics, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Shigemura
authors.forename: Kazushi
authors.initials: K
authors.lastname: Tanaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okada
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Nakano
authors.forename: Shohiro
authors.initials: S
authors.lastname: Kinoshita
authors.forename: Akinobu
authors.initials: A
authors.lastname: Gotoh
authors.forename: Soichi
authors.initials: S
authors.lastname: Arakawa
authors.forename: Masato
authors.initials: M
authors.lastname: Fujisawa
mesh_terms: D024881:Drug Resistance, Bacterial; D013293:Enterococcus faecalis / Q000187:drug effects / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000382:microbiology; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D007564:Japan; D016106:Methicillin Resistance; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000382:microbiology; D016868:Serratia Infections / Q000188:drug therapy / Q000382:microbiology; D012706:Serratia marcescens / Q000187:drug effects / Q000302:isolation & purification; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000382:microbiology*