Urinary tract infection caused by fluoroquinolone- and cephem-resistant Enterobacteriaceae.
In 2001, fluoroquinolone-resistant Escherichia coli isolates emerged in Japan in patients with uncomplicated urinary tract infection (UTI), and accounted for ca. 8% of isolates. This is a worldwide occurrence as reported by the ECO.SENS study. The number of fluoroquinolone- and cephem-resistant Enterobacteriaceae isolates from patients with complicated UTI is increasing. Most cephem-resistant isolates of E. coli, Klebsiella pneumoniae and Proteus mirabilis produce extended-spectrum beta-lactamases (ESBLs). The rates of ESBL-producing Enterobacteriaceae differ between countries but there are ESBL producers in urinary Enterobacteriaceae isolates in most countries. More seriously, most nosocomial ESBL producers are also resistant to non-beta-lactams, such as the fluoroquinolones, fosfomycin and co-trimoxazole. This causes serious problems in the chemotherapy of cystitis.
Muratani
Tetsuro
T
Department of Urology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan. muratani@med.uoeh-u.ac.jp
Matsumoto
Tetsuro
T
D015296:Ceftizoxime / Q000031:analogs & derivatives / Q000494:pharmacology; D002511:Cephalosporins / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000254:growth & development / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000382:microbiology* / Q000652:urine; D024841:Fluoroquinolones / Q000494:pharmacology*; D006801:Humans; D014552:Urinary Tract Infections / Q000382:microbiology* / Q000652:urine; D018440:beta-Lactam Resistance; D000097623:Cefpodoxime
D015296:Ceftizoxime; D002511:Cephalosporins; D024841:Fluoroquinolones; D000097623:Cefpodoxime