Trends in antimicrobial resistance of major gram-negative uropathogens, 2016-2024: A single center retrospective study
Abstract
Purpose: Resistance to empiric antimicrobials has become markedly higher among gram-negative uropathogens in Korea, compared to those in Europe and North America. To guide empiric treatment strategies and to build real evidence, we conducted a retrospective analysis of antimicrobial susceptibility patterns from urine cultures obtained at a university hospital.
Materials and methods: Antimicrobial susceptibility test (AST) results from initial positive urine cultures (n=11,358, both inpatients and outpatients) collected between 2016 and 2024 were reviewed. The analysis focused on predominant gram-negative isolates-Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, and Pseudomonas aeruginosa. Resistance rates were determined for twelve commonly used antimicrobials, including third- and fourth-generation cephalosporins, β-lactam/β-lactamase inhibitor combinations, carbapenems, aminoglycosides, fluoroquinolones, trimethoprim/sulfamethoxazole, nitrofurantoin, and fosfomycin.
Results: Between 2016 and 2024, AST identified E. coli (n=6,533), K. pneumoniae (n=1,348), P. mirabilis (n=677), and P. aeruginosa (n=663). While fluoroquinolone resistance remained persistently high (31.5%-44.5% in E. coli, 6.9%-37.0% in K. pneumoniae), its annual trend showed to be stable. Cefepime resistance increased steadily in most gram-negative isolates (annual percentage change [APC]=16.1%-25.0%). Although Carbapenem resistance remained low but it increased steadily in E. coli and K.…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 11,358 participants or records.
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