Abstract
This study retrospectively investigated the annual incidence, first-line antibiotic therapy, and risk factors for extended-spectrum β-lactamase (ESBL)-producing upper urinary tract infection (UUTI). The 166 cases of UUTI at our hospital from April 2009 to March 2013 were divided into 2 groups: UUTI due to ESBL-producing bacteria (group A, 28 cases), and UUTI due to non-ESBL-producing bacteria (group B, 138 cases). The bacteriuria in group A consisted of Escherichia coli (25 cases), Klebsiella oxytoca (2 cases), and K. pneumoniae (1 case). In both group A and B, the annual incidence of UUTI increased during the study period. Treatment antibiograms in group A showed that cefmetazole (CMZ), meropenem (MEPM), flomoxef (FMOX), imipenem/cilastatin sodium (IPM/CS), and amikacin (AMK) had 100% sensitivity. Twelve cases of ESBL-UUTI were resistant to the selected antibiotics. However, those patients were treated without changing antibiotics. The mean duration of intravenous antibiotic therapy in group A was significantly longer than in group B (8.0 vs. 6.0 days; P=0.001). There were no significant differences in age, sex, congenital anomalies of the kidney urinary tract or the number of cases treated with prophylactic antibiotics between groups. Our data suggest that the annual incidence of ESBL-UUTI is increasing; and in cases of UUTI, antibiotics against ESBL-producing bacteria should be considered.
