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Escherichia coli Enterococcus faecalisstreptococcus agalactiae Klebsiella pneumoniae Staphylococcus epidermidis E. colie. faecalispseudomonas aeruginosa K. pneumoniae S. agalactiae E. coli E. coli μ p p p p p Key words

I Corynebacterium Lactobacillus Staphylococcus aureus μ gyra parc

μ Table. Antibacterialagentbreakpointsreferencing CLSI Antibacterial agent Susceptible <_ <_ <_ <_ <_ <_ Intermediate Resistant >_ >_ >_ >_ >_ >_,,anddonothaveclsibreakpoints,sovalues forsimilardrugswereused. μ μ II Infectious disease diagnosis Enrolled:, Acute uncomplicated,66 Complicated, Excluded from an analysis: Missing case record card 3 Bacterial count insufficient 7 Asymptomatic Excluded disease 6 pyuria Already given antibacterial, clinically improved Only nonpathogenic bacteria detected 3 Catheter Overlapping 6 Infectious disease diagnosis Evaluated:,96 Acute uncomplicated,37 Complicated 63 Fig.. Subjectsdisposition.

Gender Age(year) Parameters Inpatient/outpatient Cystitisepisodesperyear Male Female < 6 >_ 6< 7 >_ 7 Mean±SD Inpatient Outpatient ne >_ Unknown Table. Subjectsummaries Diagnosis Premenopausal Postmenopausal Unknown Acuteuncomplicated N,37 6 67 9 9 99.±.7,3 9 6 3 3 %.. 6.9.9. 6.3. 6.6. 99.6 7.7 6...7 Complicated N 3 93 6 73 36 73.±. Urinarytractsurgery,37. 63 9. withinlastmonth Yes.. Unknown Systemicunderlying,9.7 39. disease Yes 73 3. 3. Catheter Self-catheterization Antibacterialagents usedpreviously (usedonlyforthis) Unknown Yes Yes Yes Unknown Diabetes Malignancyduringcurent treatment Cerebrovasculardisease requiringreferal Diseaseduringcorticosteroid orimmunosuppressanttherapy Others Quinolones nquinolones Antibacterialagentsused, 9. 6.3 withinmonth Yes 39 3. 7.7 P=<.inalcases. Unknown Quinolones nquinolones 6 7,37,37,3 7 3. 3.... 9...... 9..9...3..9.9 3 63 3 69 37 7 3 6 9 6 3 9 9 6 3 %..6...6 7.. 3..7 9.3 3.9.9 3.9 3.3...7..6..9 97.. 77..6 9.6.3 3..3. 3..7.

Table3. Causativeorganism isolatedin Organism Acuteuncomplicated (Cases:,37) Isolates (%) (Cases:63) Isolates (%) Gram-negative Escherichiacoli Klebsielapneumoniae Klebsielaoxytoca Citrobacterfreundi Citrobacterkoseri Enterobacteraerogenes Enterobactercloacae Proteusmirabilis Morganelamorgani Seratiamarcescens OtherEnterobacteriaceae Pseudomonasaeruginosa Otherglucose-nonfermentativerods, 6 6 3 7 9 3 6.9 3.6.3.9.9...6.....9 3 3 6 3 6 7 9 3 3.7.9...3....3..3.9.3 Subtotal, 69.7 6.9 Gram-positive MSSA MRSA Staphylococcusepidermidis Staphylococcussaprophyticus OtherCNS Streptococcusagalactiae Otherstreptococci Enterococcusfaecalis Otherenterococci Othercocci 3 7 7 33 6.9. 3.. 3..6.9 3... 6 3 6 9 7 7..6.6 3... 9.9.9.6 Subtotal 3.3 33 3. Total,699 Escherichia coli Enterococcus faecalisstreptococcus agalactiae Klebsiella pneumoniae Staphylococcus epidermidis E. colie. faecalispseudomonas aeruginosa K. pneumoniae S. agalactiae μ μ μ μ

Table. Susceptibilityof,79clinicalisolates Diagnosis (isolates) Antibacterial agent range MIC(μ g/ml) % 9% Susceptibility(%) Susceptible Resistant ALL (,699).6 >.6 6.6 >.6 3.6 >.6 >.6.6.6.6... 9.3 97.7 7.9 9.6 7. 76. 7.9.6 9. 9..3 9. Acuteuncomplicated Gram-negative (,).6.6 6.6 >.6 3.6 >.6 >.6.6.6.6... 9.3 97. 9. 9.6 9.6 9. 7.7...6 6.3. Gram-positive ().6 >.6. >.6 3.6 >.6 >... >. 9.. 7. 37. 7..3...3.6.6 ALL ().6 >.6.6 >.6 3.6 >.6 >..... 3 3 3 > 7. 7. 67. 7.7 6. 6.9 3..3 7.7 7.6 37. 37. Gram-negative ().6 >.6 6.6 >.6 3.6 >.6 >.6.6.6.6.. 6 3 3 3 > 7.3. 7. 7.7 73. 7.... 6. 9.. Gram-positive (33). >.6. >.6 3.6 >.6 >.. 6 6 3 > 6 6.7.7 7.9 69.. 33.7 6.. 3.9 9.6 66.. μ μ μ μ μ μ μ μ μ μ μ μ Escherichia coli E. coli μ μ

Table. SusceptibilitydistributionofclinicalGram-negativebacteriaisolates Bacterial Diagnosis Antibacterial MIC(μ g/ml) % strain (Isolates) agent.6... 6 3 6 > Escherichia coli Klebsiela pneumoniae Proteus mirabilis Acuteuncomplicated (,) (3) Acuteuncomplicated (6) (3) Acuteuncomplicated (7) () Pseudomonas aeruginosa (3) Seratia marcescens (9) 76 6 7 6 3 6 6 3 3 769 6 3 6 6 7 37 63 7 9 3 67 9 6 3 7 6 7 9 66 9 7 77 6 6 9 3 3 36 36 3 6 6 7 7 9 7 3 3 7 6 3 3 7 6 3 3 6 3 3 3 3 67 7.6.6.6.6 9...6.6.6.6. 9. 9%.. 6 6 3 7.6..6.6.6.6.6.6 3 3.. 36.. 3.6 3.6.6 3.6 3 6. 7 7. 6 3 3.6.6.6 3..6.6.6.6 3 3.6 3 3..6.6........... 6 3 6 9 6 3 3. 6 7 3 3 3. 3 7 3. 3 3 6 6 3 > > > 3 3 3 3. 3.. 6 3 3. 3 6 6 3 > Susceptibility (%) 9.6 97. 9. 9. 9. 93. 67.9 6.9 67. 67. 3.9. 96.7 97.7 97.7 97.7. 96.3 9.6.9 96.3 96.3 9.. 6.9 9. 9.. 69. 6. 6.... 9. 73.7 6. 36.. μ μ E. coli μ μ μ μ Klebsiella pneumoniae K. pneumoniae μ μ

Table6. SusceptibilitydistributionofclinicalGram-positivebacteriaisolates Bacterial Diagnosis Antibacterial MIC(μ g/ml) strain (isolates) agent.6... 6 3 6 > Enterococcus faecalis Streptococcus agalactiae Staphylococcus epidermidis Acuteuncomplicated () (7) Acuteuncomplicated (7) () Acuteuncomplicated (7) (3) % 9% 67 3 7 3.. 97 9 6.. 3 3 7 3 > > 7 3 6 3 7 7 3. 7 7 3 3 9 3 3. 3 6 36 > > 7 6736 9 3 3 6 7 7 3 36 33 7 37 6 3 6 6 6 6 6 9 3 9 6 3 3 7 3 3 6 6 6 6 6 3 3 3 9 3 3 9 6 3 3 7 3 6 3 7 3 7.6..6.6.6..6.6..6..6....6 3. 3 6.6.6 3. 3 6.6.6. 6. 3 Susceptibility (%) 96.9 9. 9. 96.9.9 3..7.9 69.7.7.6 3. 79. 7. 79. 6. 7. 6. 6.9 96. 9.6 9.6 9.6 6. 7. 3. 39. 7.. μ K. pneumoniae μ μ μ μ Proteus mirabilis P. mirabilis μ μ μ μ P. mirabilis μ μ μ μ Pseudomonas aeruginosa P. aeruginosa μ μ μ μ P. aeruginosa

μ μ Serratia marcescens S. marcescens μ μ μ μ S. marcescens μ μ μ μ μ μ μ μ μ μ μ μ Enterococcus faecalis E. faecalis μ μ μ μ E. faecalis μ μ μ μ Streptococcus agalactiae S. agalactiae μ μ μ S. agalactiae μ μ μ Staphylococcus epidermidis S. epidermidis μ μ μ μ S. epidermidis μ μ μ μ μ μ μ

Fig.. RelationshipbetweenMICofandQRDRmutationsintargetenzymesofE.coli. μ μ μ p p p p p III μ E. colie. faecaliss. agalactiae

Fig.3. RelationshipbetweenMICofandQRDRmutationsintargetenzymesofE.coli. K. pneumoniae S. epidermidis E. colie. faecalis P. aeruginosa K. pneumoniae S. agalactiae

Diagnosis Gender Parameters Table7. Riskfactorinquinolone-resistantEscherichiacolidetection OR Acuteuncomplicated Male Female(premenopausal) Female(postmenopausal) < 6.3.33.7 Univariate 9%CI 3.7.9.7.9.67.3 Statisticaltest <. <. <. OR. Multivariate 9%CI.33 3. Age(years) >_ 6< 7.67..9.97.7. Inpatient/outpatient >_ 7 Inpatient Outpatient ne 3.39.9.39.99.76.37.7 <..69.93.6 Cystitisepisodesperyear.7.3.9.39.9.66 Urinarytractsurgerywithinlast month Systemicunderlyingdisease Catheter Self-catheterization Antibacterialagentsusedpreviously (usedonlyforthis) Antibacterialagentsusedwithin month >_ Yes Yes Yes Yes Quinolones nquinolones Quinolones nquinolones 6.3 6.7. 6.7.6.7 6.63.77.. 9..377 97.9.6..9 3.376.96..677 7.367.79.97. 37.7.3.3.3..73 <. <. <. 3..99...3.76.99.33 3.7.77.3. 7.3..6 P.9. <. <.. μ μ

Escherichia coli

Escherichia coli E. coli Enterococcus faecalis Streptococcus agalactiae Klebsiella pneumoniae Staphylococcus epidermidis E. coli E. faecalis Pseudomonas aeruginosa K. pneumoniae S. agalactiae E. coli E. coli E. coli μ

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