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International comparison of causative bacteria and antimicrobial susceptibilities of urinary tract infections between developed and developing countries

Login to Access Video or Poster Abstract: MP23-07
Sources of Funding: none

Introduction

Causative bacteria in urinary tract infection (UTI) are generally influenced by the trend of antibiotic use and especially emergences of antibiotic resistant strains are emphasized by inappropriate antibiotic use. The use of antibiotic including infection control such as intervention for antimicrobial stewardship are varied among countries and regions; however thin kind of study spreading to several countries or regions for comparison are lacked. Under this situation, the objective of this study is to investigate the comparison of UTI-causative bacteria between developed country and developing country to clarify their frequency and the susceptibilities to the representative antimicrobial agents owing to the different uses of antibiotics.

Methods

For over 2 or 11-month, 1704 samples from the UTI patients were retrospectively analyzed (1260 ones from Kobe University Hospital, Japan and 544 ones from Soetomo Hospital, Surabaya, Indonesia). Isolated bacteria were identified, and their antibiotic susceptibilities were determined. The statistical analyses were performed for compassion of those data from both countries under the classification of pediatric UTI and adult UTI.

Results

Escherichia coli was the most common etiological agent of UTI (24.2% in Japan and 39.3% in Indonesia). Enterococcus faecalis was more often isolated in Japan (14.1%), but not in Indonesia (5.3%). Klebsiella spp. was more frequently isolated in Indonesian pediatrics (20.3%) compared to Indonesian adults (13.6%) and in Japan (6.5%). E. coli, as the most prevalent cause of UTI, was substantially resistant to ampicillin and 1st and 3rd cepharosporines in Indonesian adults but not in japan. In many cases, Indonesian isolates tended to have lower susceptibilities rates than Japanese ones. Extended-spectrum β-lactamase producing gram-negative bacteria were 5.7% in japan, 39% in Indonesian adults, and 39% in Indonesian pediatrics.

Conclusions

The results show that the antimicrobial resistance patterns of the causes of UTI are highly variable among countries and continuous surveillance of trends in resistance patterns of uropathogens is important for future revision of the use of antimicrobial agents.

Funding

none

Authors
Katsumi Shigemura
Koichi Kitagawa
Kuntaman Kuntaman
Toshiro Shirakawa
Masato Fujisawa
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