title: Risk Factor Analysis of Ciprofloxacin-Resistant and Extended Spectrum Beta-Lactamases Pathogen-Induced Acute Bacterial Prostatitis in Korea.
abstract: The objectives of this study were to investigate risk factors and the incidence of ciprofloxacin resistance and extended-spectrum beta-lactamases (ESBL) in patients with acute bacterial prostatitis (ABP). We reviewed the medical records of 307 patients who were diagnosed with ABP between January 2006 and December 2015. The etiologic pathogens and risk factors for ciprofloxacin-resistant E. coli and ESBL-producing microbes, susceptibility to ciprofloxacin, and the incidence of ESBL in patients with ABP were described. History of prior urologic manipulation was an independent risk factor for ciprofloxacin-resistant (P = 0.005) and ESBL-producing microbes (P = 0.005). Advanced age (over 60 years) was an independent risk factor for ciprofloxacin-resistant microbes (P = 0.022). The ciprofloxacin susceptibility for Escherichia coli in groups without prior manipulation was documented 85.7%. For groups with prior manipulation, the susceptibility was 10.0%. Incidence of ESBL-producing microbes by pathogen was 3.8% for E. coli and 1.0% for Klebsiella pneumonia in the absence of manipulation group, and 20% and 33.3% in the presence of manipulation group, respectively. Initial treatment of ABP must consider patient's age and the possibility of prior manipulation to optimize patient treatment. With the high rate of resistance to fluoroquinolone, cephalosporins with amikacin, or carbapenems, or extended-spectrum penicillin with beta lactamase inhibitor should be considered as the preferred empirical ABP treatment in the patients with history of prior urologic manipulation.
authors.affiliation: Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Young
authors.identifier: http://orcid.org/0000-0003-0737-0293
authors.initials: Y
authors.lastname: Lee
authors.affiliation: Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Dong Gi
authors.identifier: http://orcid.org/0000-0001-7369-9252
authors.initials: DG
authors.lastname: Lee
authors.affiliation: Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Sang Hyub
authors.identifier: http://orcid.org/0000-0002-4509-5846
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea. yookoohan@khu.ac.kr.
authors.forename: Koo Han
authors.identifier: http://orcid.org/0000-0001-7952-7902
authors.initials: KH
authors.lastname: Yoo
mesh_terms: D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D000368:Aged; D000583:Amikacin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D002511:Cephalosporins / Q000494:pharmacology; D002939:Ciprofloxacin / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects / Q000201:enzymology / Q000302:isolation & purification; D006801:Humans; D015378:Imipenem / Q000494:pharmacology; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000201:enzymology / Q000302:isolation & purification; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011472:Prostatitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D002939:Ciprofloxacin; D015378:Imipenem; D000583:Amikacin; D001618:beta-Lactamases
keywords: Acute Bacterial Prostatitis; Ciprofloxacin; Extended-spectrum Beta-lactamases; Risk Factors