Jpn. J. Infect. Dis., 58 (5), 303-308, 2005
To see a printable version of the article in the Adobe file format, click this [PDF] link.
Original Article
Pathogen Occurrence and Antimicrobial Susceptibility of Urinary Tract Infection Cases during a 20-Year Period (1998-2002) at a Single Institution in Japan
Katsumi Shigemura, Kazushi Tanaka*, Hiroshi Okada1, Yuzo Nakano, Shohiro Kinoshita3, Akinobu Gotoh2, Soichi Arakawa and Masato Fujisawa
Division of Urology, Department of Organs Therapeutics, Faculty of Medicine and 2International Center for Medical Research, Kobe University Graduate School of Medicine, 3Clinical Laboratory, Kobe University Hospital, Kobe 650-0017 and 1Department of Urology, Teikyo University School of Medicine, Tokyo 173-8606, Japan
(Received March 28, 2005. Accepted August 17, 2005)
*Corresponding author: Mailing address: Division of Urology, Department of Organs Therapeutics, Faculty of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. Tel: +81-78-382-6155, Fax: +81-78-382-6169, E-mail address: kazushi@med.kobe-u.ac.jp
SUMMARY: Urinary tract infections are one of the most common infectious diseases diagnosed in outpatients as well as in hospitalized patients. Recently, urinary tract infections have become more complicated and difficult to treat. Therefore, the present study analyzed the occurrence and antimicrobial susceptibility of uropathogens isolated at Kobe University Hospital between 1983 and 2002. This study was performed with three patient groups: urology inpatients, urology outpatients, and inpatients of other departments. During the 20-year study period, we studied 15,925 urine isolates obtained from those patients who were diagnosed with urinary tract infection. Overall, Enterococcus faecalis was the most frequently isolated pathogen, followed by Pseudomonas aeruginosa and Escherichia coli. The frequency of Staphylococcus aureus increased over time, corresponding to an increase in the occurrence of methicillin-resistant S. aureus (MRSA). In addition, the rate of isolation of Serratia marcescens also increased over time, especially among patients with urinary tract catheters. Our results demonstrate that the uropathogens isolated at a single institution have shown a trend of increasing resistance to various classes of antimicrobial agents. In addition, serious problems should be anticipated in the treatment of multidrug-resistant P. aeruginosa, fluoroquinolone-resistant E. coli, and arbekacin-resistant MRSA.