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KMID : 0338420110260010089
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The Korean Journal of Internal Medicine
2011 Volume.26 No. 1 p.89 ~ p.93
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Epidemiology of Ciprofloxacin Resistance and Its Relationship to Extended-Spectrum β-Lactamase Production in Proteus mirabilis Bacteremia
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Sohn Kyung-Mok
Kang Cheol-In
Joo Eun-Jeong
Ha Young-Eun
Chung Doo-Ryeon
Peck Kyong-Ran
Lee Nam-Yong
Song Jae-Hoon
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Abstract
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Background/Aims: We evaluated the clinical features of ciprofloxacin-resistant Proteus mirabilis bacteremia and
risk factors for ciprofloxacin resistance.
Methods: From October 2000 to July 2009, 37 patients with clinically significant P. mirabilis bacteremia were
identified and data from patients with ciprofloxacin-resistant and ciprofloxacin-susceptible P. mirabilis bacteremia were compared.
Results: The most common underlying diseases were neurologic disease (37.8%) and solid tumors (29.7%). The
most common site of infection was the urinary tract (35.1%). Ten of the 37 patients (27.0%) were infected with ciprofloxacin-resistant isolates, and univariate analysis revealed a significant relationship between ciprofloxacinresistant
P. mirabilis bacteremia and neurologic disease, recent operation, L-tube insertion, percutaneous tube use, and extended-spectrum β-lactamase (ESBL) production (all p < 0.05). ESBL was detected in six of 10 (60%) ciprofloxacin-resistant isolates, while only three of 27 (11%) ciprofloxacin-susceptible isolates produced ESBL (p = 0.005). In a logistic regression analysis, ESBL production remained a significant factor associated with ciprofloxacin resistance, after adjusting for other variables.
Conclusions: These data indicate a close association between ciprofloxacin resistance and ESBL-production in
P. mirabilis bacteremia. This association is particularly troublesome because the therapeutic options for serious infections caused by ESBL-producing P. mirabilis are severely restricted.
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KEYWORD
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Proteus mirabilis, Ciprofloxacin, Drug resistance, Bacterial, Risk factors, Cephalosporin resistance
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