Acute uncomplicated cystitis in the emergency department: prevalence of antimicrobial resistance among uropathogens and appropriate antimicrobial treatment

Chung, Soo Young; Kim, Youngsik; Jeong, Rubi; Lee, KyooHyun; Yu, Woosung; Yoon, Youngtak; Choi, Seungju

J Korean Soc Emerg Med > Volume 33(5); 2022 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2022;33(5): 480-486.

응급의료센터에서 진단된 급성 단순 방광염 환자의 항생제 내성률 및 적절한 항생제에 대한 고찰

정수용

분당제생병원 응급의학과

Acute uncomplicated cystitis in the emergency department: prevalence of antimicrobial resistance among uropathogens and appropriate antimicrobial treatment

Department of Emergency Medicine, Daejin Medical Center, Bundang Jesaeng General Hospital, Seongnam, Korea

Correspondence

Youngsik Kim ,Tel: 031-779-0000, Fax: 031-779-0929, Email: emckys@dmc.or.kr,

Received: October 14, 2021; Revised: November 3, 2021 Accepted: November 9, 2021. Published online: October 31, 2022.

ABSTRACT

Objective:
This study analyzed the urine cultures of emergency department patients diagnosed with acute uncomplicated cystitis and determined the antimicrobial resistance and appropriate treatment for our region.
Method:
Results of urine analysis and urine culture of acute uncomplicated cystitis patients diagnosed in our emergency department between January 2019 and December 2020 were examined and analyzed.
Results:
In our study, 256 out of 340 urine culture samples (75.3%) were positive for cystitis. The most common microorganism was reported to be Escherichia coli (93.0%). The resistance rates of E. coli to the following antimicrobial agents were as follows: amikacin (0.0%), ampicillin (63.5%), amoxicillin/clavulanate (15.6%), aztreonam (7.1%), ceftazidime (3.4%), cefotaxime (16.4%), cefoxitin (5.5%), cefazolin (19.9%), ciprofloxacin (29.4%), cefepime (1.7%), ertapenem (0.0%), gentamicin (18.1%), piperacillin/tazobactam (2.1%), trimethoprim/sulfamethoxazole (36.1%), and tigecycline (0.4%). The prevalence of extended-spectrum beta-lactamase producing E. coli strains was 17.8%.
Conclusion:
To determine the proper empirical antimicrobial treatment for acute uncomplicated cystitis, it is essential to examine the antimicrobial resistance. For our region, fosfomycin, nitrofurantoin, and 2nd and 3rd generation cephalosporin should be considered the first-line empirical treatment for acute uncomplicated cystitis.

Key words: Cystitis; Antibiotics; Drug resistance; Emergency department