title: Chronological change of antibiotic use and antibiotic resistance in Escherichia coli causing urinary tract infections.
abstract: Overuse of antibiotics can cause the emergence of resistant bacterial strains. This study retrospectively investigated recent trends in Escherichia coli causing urinary tract infections (UTIs), focusing on antibiotic use and antibiotic susceptibilities. Patients diagnosed with UTIs caused by E. coli in Akashi Municipal Hospital between April 2004 and March 2010 were enrolled in the study. A total of 858 UTI cases were examined. Antibiotics used in our hospital during that period and the antibiotic susceptibilities of E. coli in UTI cases were assessed. We analyzed the data on a yearly basis, with the year being defined as the period from April to the following March (e.g., in this study the period from April 2004 to March 2005 represents 2004). The first 3 years (2004-2006) were compared to the last 3 years (2007-2009). The use of piperacillin, cephazolin, amikacin, oral cefotiam, and levofloxacin decreased significantly and the use of imipenem, gentamicin (GM), cefcapene, and oral minocycline (MINO) increased significantly in the last 3 years compared to the previous 3 years. The susceptibilities of MINO in complicated cystitis significantly increased and those of GM in uncomplicated pyelonephritis significantly decreased in these 3 years (2007-2009) compared to the previous 3 years (2004-2006) (P < 0.05). Additionally, extended-spectrum β-lactamase (ESBL)-producing E. coli tended to be isolated more often; this was statistically significant in the last 3 years (2007-2009) compared to the previous 3 years (2004-2006) (P < 0.05). In conclusion, we found changes in our pattern of antibiotic use associated with changes in antibiotic susceptibilities and an increase in ESBL-producing E. coli isolated from our UTI cases. Monitoring of antibiotic use and emergence of resistant strains should be continued.
authors.affiliation: Department of Urology, Akashi Municipal Hospital, Akashi, Japan.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Shigemura
authors.forename: Kazushi
authors.initials: K
authors.lastname: Tanaka
authors.forename: Masayo
authors.initials: M
authors.lastname: Adachi
authors.forename: Masuo
authors.initials: M
authors.lastname: Yamashita
authors.forename: Soichi
authors.initials: S
authors.lastname: Arakawa
authors.forename: Masato
authors.initials: M
authors.lastname: Fujisawa
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D011307:Drug Prescriptions; D004926:Escherichia coli / Q000187:drug effects* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy* / Q000382:microbiology*; D005260:Female; D006801:Humans; D057970:Inappropriate Prescribing; D007564:Japan; D008297:Male; D008826:Microbial Sensitivity Tests; D016017:Odds Ratio; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology*; D018440:beta-Lactam Resistance
chemical_list: D000900:Anti-Bacterial Agents